What are the symptoms of angiographic nephropathy?

summary

Contrast induced nephropathy (can) refers to the rapid decline of renal function caused by contrast agent. In order to avoid this, female friends must take precautions. The commonly used contrast agents are usually hypertonic, with iodine content as high as 37%. In vivo, the contrast agents are filtered through the glomeruli without being absorbed by the renal tubules. When dehydrated, the concentration of the contrast agents in the kidney increases, which can cause renal damage and acute renal failure. For patients with high risk factors, angiography should be avoided as far as possible. So what are the symptoms of angiographic nephropathy? What about it? Let's take a look at it.

What are the symptoms of angiographic nephropathy?

First, the serum creatinine of the patients receiving the contrast medium usually rises within 24 hours, reaches the peak at 96 hours, and generally returns to the basic value after 7-10 days. However, it was also reported that renal function decreased progressively within 1-3 weeks, and then returned to the basic value.

Second: more than 60% of can patients have oliguria in the early stage, and they are resistant to diuretics. Most patients with renal function can recover naturally, 10% of them need dialysis treatment, and irreversible renal failure is rare, which needs long-term maintenance of dialysis. Urine examination showed renal tubular epithelial cells, tubular type and various fragments in urine, which was non-specific and not related to the changes of renal function.

Third: urate crystal common, occasionally visible calcium citrate crystal, a large number of proteinuria is not common. In most patients with acute tubular necrosis, the urinary sodium excretion was more than 40 mmol / L, and the fractional sodium excretion (FENa) was more than 1%; However, one third of patients with acute renal failure had lower urinary sodium excretion than 20 mmol / L, and the fraction of sodium excretion in patients with oliguria was less than 1%.

matters needing attention

(1) Calcium channel blockers have been shown to inhibit renal vasoconstriction induced by contrast media in dogs. Calcium antagonists can prevent renal ischemia by inhibiting intracellular calcium influx, block renal vasoconstriction and prevent tubular cell death（ 2) Angiodilator (1) atrial natriuretic peptide (ANP) can prevent can and block the decrease of renal blood flow and GFR induced by contrast medium. ANP in aorta can reduce the decrease of creatinine clearance rate and renal blood flow caused by contrast medium. ② Adenosine antagonist test showed that in a group of 40 cases serum creatinine ≤ 160 μ The CCR of the adenosine antagonist group decreased by 21% after the contrast medium was given to the patients at the dose of 10 mmol / L ± CCR decreased by 39% in the placebo group ± 5% (P < 0.05), it was considered that it had a certain protective effect on renal vasoconstriction induced by contrast medium.