Contrast Induced Nephropathy - Essay Example

"Contrast-Induced Nephropathy " is a controversial example of a paper on dermatology.
Contrast-induced nephropathy (CIN) is neurotoxicity of the kidney that is induced by the contrast agents when administered to the patient. It results in the impairment of the real function. In this case, Iatrogenic renal function impairment results from exposure to contrast media. 11% of hospital-acquired renal failure comes from radiographic contrast media

1.1 Three parts that define Contrast-induced nephropathy (CIN)

The consideration for increasing levels of serum creatinine in comparison to baseline values

This is the most common contrast-induced nephropathy today with an absolute increase of 0.5 mg/dl or more for serum creatinine values from baseline values between 2-3 days following exposure to contrast media. The first 24 hours after exposure appear to be important in the development of the contrast-induced nephropathy

Relationships that are temporal existence occurring between serum creatinine rise and exposure to a contrast agent

A causal study of the increase of creatinine in the prevention of Radiocontrast Induced Nephropathy Clinical Evaluation trial indicated that in 80% of contrast-induced nephropathy cases. Serum creatinine started to rise within the first day of contrast media exposure, and nearly all patients who progressed to serious renal failure had a rise in serum creatinine within the first-time frame. The study further showed that patients with less than 0.5mg/dl with a complete rise of the serum creatinine taken within the time for a period of 24 hours with conditions that make known the clinical meaning and the form which contrasts the induced nephropathy (Nikolsky, 2006).

Exclusion of alternative explanations for renal impairment

Patients having cardiovascular pathology have a higher prevalence of contrast-induced nephropathy. A study conducted in Mayo clinic showed that for 7586 patients who had cardiological issues the number of new cases of contrast-induced nephropathy was 3.3% making it around 250 patients. For a smaller study at William Beaumont Hospital, 1826 patients treated with angioplasty, contrast-induced nephropathy occurred in 14.5% of the cases (264 patients).

• What does LVEF stand for?

Left ventricular ejection fraction: this refers to the measurement of the amount of blood that leaves the left ventricle upon contraction of the heart muscles (Nikolsky, 2006). 

• What is the difference between modifiable and fixed risk factors?

Modifiable risk in terms of factors can be considered as those that can be treated or controlled to prevent the predisposition of certain diseases at a later stage.

• Modifiable factors include Hypotension, Dehydration, Diuretics, Low serum albumin level
• Non-modifiable (Fixed factors) are those that cannot be controlled and thus predispose one to get the disease.
  Non-modifiable factors include; older age, Diabetes mellitus, Low left ventricular ejection fraction and renal transplant

1.4 What labs and value ranges do you use at your site to determine renal function?

Normal adult range:

Blood urea nitrogen 7-18 mg/dl f

Creatinine:

Serum: 0.6-1.2 mg/dl

Urine (male): 0.8-2.4 g/24hr

Urine (female): 0.6-1.8 g/24hr

Creatinine clearance (male): 97-137 mL/min

Creatinine clearance (female): 88-128 mL/min (Nikolsky, 2006).

1.5 Views as a CT technologist of administering contrast agents to a patient and how to facilitate post-exam report

It is rather confusing knowing that some contrast agents have been used in the past and have given different results. It makes one feel that they will be putting the patient’s life at more risk. It is important to conduct an individual patient risk-benefit analysis prior to the administration of contrast media to the patient at risk of developing contrast-induced nephropathy (Nikolsky, 2006).

The post-exam instructions are necessary as they will help the patient understand the possibility of developing the nephrotoxicity and in the likely event, this would help mitigate this risk eventually. It would be important for the patient to know why the contrast media are being administered, and the risk involved, and hence I would explain this to nullify any concern (Nikolsky, 2006).

2.0 CONCLUSION

Contrast-induced nephropathy is a medical condition that results from the administration of contrast media. It is a rare condition but mostly affects people having renal impairment, anemia, diabetes, and the elderly. A careful risk-benefit analysis is mandatory prior to administering the contrast agents to patients risk of CIN.