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FACP. Colegio de médicos de Tarragona Nº 4305520 / fgcapriles@gmail.com

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My Heart is Racing! Select Cardiac Arrhythmias and Practice Updates

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lunes, 22 de junio de 2015

Nefropatía por contraste

Boring EM - June, 22, 2015 - By Michael Garfinkle
"I once encountered a patient who was empirically started on warfarin therapy after a presumed diagnosis of pulmonary embolus. The treating team did not want to risk an AKI by performing a CT-PE as the patient’s creatinine was 120 and a V/Q scan was not an option due to underlying lung disease. This made me uncomfortable. There’s a known risk of hemorrhagic stroke (~0.5% per year) and other major bleeding events with warfarin, which should be weighed against the risk of AKI and the need for dialysis from contrast-induced nephropathy from CT-PE.
But what is that risk? Surprisingly, the literature is equivocal on this very important question. This spurred me to do my own study to better approximate this risk. The following discussion will reference this study as well as a few other well designed, recently published studies that have challenged the common assumption that contrast in CKD = high risk of permanent renal injury."
http://boringem.org/2015/06/22/what-is-the-risk-of-contrast-induced-nephropathy/