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Chapter 19: Renal Complications of Contrast Media

Anand Prasad; Peter A. McCullough

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    AMA Citation
    Prasad A, McCullough PA. Prasad A, McCullough P.A. Prasad, Anand, and Peter A. McCullough.Renal Complications of Contrast Media. In: Samady H, Fearon WF, Yeung AC, King III SB. Samady H, Fearon W.F., Yeung A.C., King III S.B. Eds. Habib Samady, et al.eds. Interventional Cardiology, 2e New York, NY: McGraw-Hill; . http://accesscardiology.mhmedical.com/content.aspx?bookid=2256&sectionid=173995516. Accessed February 18, 2019.
    MLA Citation
    Prasad A, McCullough PA. Prasad A, McCullough P.A. Prasad, Anand, and Peter A. McCullough.. "Renal Complications of Contrast Media." Interventional Cardiology, 2e Samady H, Fearon WF, Yeung AC, King III SB. Samady H, Fearon W.F., Yeung A.C., King III S.B. Eds. Habib Samady, et al. New York, NY: McGraw-Hill, , http://accesscardiology.mhmedical.com/content.aspx?bookid=2256&sectionid=173995516.

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Chapter 19. Renal Complications of Contrast Media

Which of the following statements is true about contrast-induced acute kidney injury (CI-AKI)?

A. It is the most common cause of hospital-acquired renal failure.

B. The incidence of CI-AKI is well defined in the literature and is approximately 20%.

C. One percent of episodes of CI-AKI require dialysis.

D. Episodes of CI-AKI not requiring dialysis add, on average, 7 days to the hospitalization.

The correct answer is C

Which of the following statements is true about transient rises in serum creatinine following contrast administration?

A. Changes >0.1 mg/dL are considered significant.

B. A rise of >0.3 mg/dL in serum creatinine occurs in approximately 7% of patients undergoing percutaneous coronary intervention (PCI).

C. Transient rises in serum creatinine have not been associated with adverse long-term outcomes.

D. Definitions of CI-AKI have had consistent criteria with respect to acute changes in serum creatinine.

The correct answer is B

Which of the following statements is true about biomarkers for CI-AKI?

A. Tubular markers for AKI, including liver-type fatty acid binding protein, kidney injury molecule-1, and neutrophil gelatinase-associated lipocalin, have improved sensitivity for renal injury as compared to serum creatinine.

B. Serum creatinine changes provide rapid detection of renal injury following contrast administration.

C. Cystatin C is a tubular marker that is upregulated during AKI.

D. Changes in urine creatinine levels are more reliable than serum creatinine for AKI.

The correct answer is A

Which of the following occurs after contrast administration?

A. Prolonged renal vascular vasodilation

B. A brief increase in renal blood flow followed by prolonged vasoconstriction

C. No acute changes in renal perfusion

D. An acute decline in renal vein renin levels

The correct answer is B

Which of the following statements is true about management and prevention of CI-AKI?

A. Metformin-induced lactic acidosis is most common in non–insulin-dependent diabetics with underlying renal dysfunction.

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