CONTRAST-INDUCED NEPHROPATHY IN INTERVENTIONAL CARDIOLOGY AND ANGIOLOGY

Аннотация

Cardiovascular diseases are the leading cause of death in industrialized countries. High-quality and accurate diagnostics, including cardiac and vascular imaging, are of great importance for adequate assessment, treatment, and prevention of cardiovascular diseases. Intravenous or intra-arterial administration of radiocontrast agents (or simply contrast agents) allows for precise determination of the vascular anatomy, the nature and localization of lesions in them, and assessment of the blood supply to various organs and tissues. Without such information, modern treatment would be simply impossible. Selective angiography and computed tomography with the introduction of contrast agents (CA) are used everywhere in practical medicine. Therefore, safety issues of examination or intervention using CA are of great importance. Despite significant progress in the development of CA, they have a number of adverse effects, including nephrotoxicity. Prevention of the nephrotoxic effect of CA, the so-called contrast-induced nephropathy (CIN), remains a pressing issue, since It is known that CIN is often a harbinger of chronic renal failure, which worsens the prognosis (McCullough, P. A. et al. 1997, Rihal, C. S. et al. 2002). Active use of X-ray computed tomography with intravenous administration of KB at the diagnostic stage increases not only the total radiation load, but also nephrotoxicity. Endovascular interventions, in which the risk of developing CIN is increased, are increasingly carried out in severely ill older patients with multifocal atherosclerosis, diabetes mellitus, arterial hypertension, heart failure, chronic kidney disease, etc. The interventions themselves are becoming more complex, often multi-stage, with the use of a large volume of KB. The dissertation is devoted to a topical issue - the prevention of CIN in patients who undergo endovascular interventions on the coronary and peripheral arteries.