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Topic: Radiocontrast

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	Hypersensitivity Reactions to Radiocontrast Media: The Role of Complement Activation
		Radiocontrast media can be classified according to their iodine content, osmolarity (hyper-, low-, and iso-osmolar), level of ionization (ionic and nonionic), and level of polymerization (monomeric and dimeric).
		Radiocontrast media-induced, nonspecific proteolysis without participation of the multicomponent C3/C5 convertases might deserve particular attention, because it explains the concurrent activation of coagulation, fibrinolysis, and the kinin-kallikrein systems in humans.
		Radiocontrast media reactions have several risk factors, including tendencies toward allergy (atopic constitution) and asthma, and a history of previous reactions to RCM or other drugs.
	www.current-reports.com /article.cfm?PubID=AL04-1-1-03&Type=Article&KeyWords= (3293 words)

	Drugs to be used with caution in patients with asthma - includes patient information sheet American Family Physician - ...
		Radiocontrast agents, beta-adrenergic blocking agents (beta blockers), and aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs) can precipitate asthma symptoms and should be used with care in patients with asthma.
		A review of approximately 30,000 procedures using radiocontrast agents reported that about 1 percent of the procedures resulted in an adverse reaction; the reaction was serious in 0.1 percent, and fatal reactions occurred in 0.01 percent.
		In an attempt to reduce the rate of reactions to radiocontrast agents used in diagnostic procedures, a placebo-controlled, multicenter study was performed.[3] Patients received one or two doses of methylprednisolone, 32 mg orally, before the procedure.
	www.findarticles.com /p/articles/mi_m3225/is_n3_v54/ai_18724106 (717 words)

	Postgraduate Medicine: Renal Problems Symposium: Nephrolithiasis
		The acute decline in renal function after administration of radiocontrast media is the third leading cause of hospital-acquired acute renal failure.
		Radiocontrast nephropathy is usually recognized 1 or more days after administration of contrast material.
		Even though nonionic radiocontrast agents (ie, iopamidol [Isovue], iohexol [Omnipaque]) are less nephrotoxic than ionic agents (ie, diatrizoate meglumine, iothalamate meglumine [Cysto-Conray-II]), there is insufficient evidence to justify the use of the former in patients with normal renal function (13).
	www.postgradmed.com /issues/1996/12_96/thatte.htm (4472 words)

	Coronary catheterization - Wikipedia, the free encyclopedia
		Typically 3-8 cc of the radiocontrast agent is injected for each image to make the blood flow visible for about 3-5 seconds as the radiocontrast agent is rapidly washed away into the coronary capillaries and then coronary veins.
		The radiocontrast within the blood allows visualization of the blood flow within the arteries or heart chambers, depending on where it is injected.
		The radiocontrast filled balloon is watched under fluoroscopy (it typically assumes a "dog bone" shape imposed on the outside of the balloon by the stenosis as the balloon is expanded), as it opens.
	en.wikipedia.org /wiki/Coronary_angiogram (1755 words)

	Radiocontrast - Wikipedia, the free encyclopedia
		Radiocontrast agents (also simply contrast agents or contrast materials) are compounds used to improve the visibility of internal bodily structures in an X-ray image.
		Contrast agents are also used in MRI (Magnetic Resonance Imaging).
		The major side effects of radiocontrast are anaphylactoid reactions and contrast-induced nephropathy.
	en.wikipedia.org /wiki/Radiocontrast (1121 words)

	Postgraduate Medicine: Common allergic and allergic-like reactions to medications
		Radiocontrast media activate mast cells and basophils by a nonspecific mechanism.
		Increased risk of serious reactions to radiocontrast media has been reported in patients receiving beta-adrenergic antagonists, patients with a previous history of reaction, and those with underlying cardiovascular disease, especially congestive heart failure, or asthma.
		In patients with a previous history of reaction to radiocontrast agents, the incidence of a second adverse reaction may be as high as 35% (24).
	www.postgradmed.com /issues/1999/03_99/craig.htm (2971 words)

	Theophylline for the prevention of radiocontrast nephropathy: a meta-analysis -- Ix et al. 19 (11): 2747 -- Nephrology ...
		Radiocontrast nephropathy is a common cause of acute
		Radiocontrast nephropathy is a common cause of acute renal failure
		response of the kidney to radiocontrast is biphasic.
	ndt.oxfordjournals.org /cgi/content/full/19/11/2747 (2754 words)

	Publication Search
		Moreover, in an animal model of radiocontrast-induced nephropathy (RCIN), it was recently demonstrated that early renal hemodynamic responses to radiocontrast are attenuated by intra-arterial atrial natriuretic factor (ANF), which prevents subsequent RCIN.
		infusion of radiocontrast produces increases in endogenous plasma and urinary ET and whether these responses are modulated by intra-arterial ANF in an animal model of RCIN.
		radiocontrast in the presence and absence of an intra-aortic infusion of ANF.
	mdev.temple.edu /cvresearch/PublicationSearchResults.asp?txtCAT=13 (1158 words)

	Dr. Hale's Breastfeeding and Medications Forum: IVP Intravenous Pyelogram
		While these are 'iodinated' radiocontrast agents, the iodine is covalently bound and for the most part is not bioavailable, but passes rapidly in the urine.
		Following the radiocontrast agent, the patient is examined with X-ray which is not at all contraindicated in breastfeeding patients.
		These radiocontrast agents are for the most part unabsorbed orally.
	neonatal.ama.ttuhsc.edu /discus/messages/55/407.html?1065454027 (170 words)

	UpToDate Pathogenesis, clinical features, and diagnosis of radiocontrast media-induced acute renal failure
		— The administration of radiocontrast media can lead to a usually reversible form of acute renal failure that begins soon after the contrast is administered [1-11].
		Second generation agents, such as iohexol, are nonionic monomers with a lower osmolality than the first generation radiocontrast media; however, they still have an increased osmolality (500 to 850 mosmol/kg) compared with plasma.
		Preventive strategies for reducing the risk of contrast nephrotoxicity, and a discussion of acute tubular necrosis, the most common cause of acute renal failure developing in hospitalized patients, are presented separately.
	patients.uptodate.com /print.asp?print=true&file=renlfail/9576 (471 words)

	Ask an Expert: Braclet
		If you do need to have a procedure in the future requiring radiocontrast media, they should use low osmolality material and pre-treat you at least 13 hours before the procedure with Prednisone 50mg every 6 hours up until one hour before the procedure.
		This is a published protocol for pre-treatment of patients with radiocontrast media reactions.
		The reaction is not due to the iodine in the radiocontrast media.
	www.netwellness.org /question.cfm/15309.htm (306 words)

	Diagnostic Dyes May Put Patients at Risk (Site not responding. Last check: 2007-11-07)
		Researchers at the VA Pittsburgh Healthcare System and the University of Pittsburgh School of Medicine analyzed data on nearly 11,500 patients who had a coronary angiography to evaluate possible heart disease.
		For this test, radiocontrast dye is injected into the patient's blood vessels in order to highlight the coronary arteries on the X-ray images.
		In this study, changes in the patients' serum creatinine levels (an indicator of kidney function) were evaluated before and after they were injected with the dye.
	www.cbc.ca /cp/HealthScout/060823/6082314U.html (272 words)

	Allergy & Asthma Disease Management Center: Ask the Expert: Radiocontrast Reactions
		Despite comments sometimes made in the lay media and by some physicians, there is no evidence supporting the contention that shellfish allergy has anything to do with the iodine content of such foods.
		I have an asthmatic patient with renal disease he is in need for IVU, the radiologist insist to give pre-medications [steroids and antihistamine] I reviewed the literature and could not find a standard protocol for asthmatic patient who never had a reaction to radio contrast media.
		However, there appears to be a definite increased incidence of asthmatic flares in reaction to the RCM injection.
	www.aaaai.org /AADMC/ate/radiocontrast.html (2454 words)

	Ask an Expert: CT Scan dye allergy
		Allergic reactions to radiocontrast dye are not uncommon but usually occur within the first 30 minutes after injection of the dye.
		Although the stomach pain could be related to your procedure, it is unlikely that the hives one week later are causally related to the radiocontrast media injection.
		Iodine is not the cause of allergic reactions to dye; rather, it is the high molecular weight nature of the material that triggers the release of histamine from mast cells which causes diffuse itching, hives, fall in blood pressure and gastrointestinal symptoms.
	www.netwellness.org /question.cfm/8675.htm (292 words)

	Radiocontrast
		Radiocontrast agents (or simply contrast agents) are compounds used to improve the visibility of internal bodily structures in an X-ray image.
		Endovascular therapeutic hypothermia may help prevent radiocontrast nephropathy, a cause of kidney failure, according to the results of a clinical feasibility trial presented at the recent American Heart Association's Scientific Sessions 2006 in Chicago.
		SAN DIEGO----FibroGen, Inc. today announced preclinical data showing that FG-4539, a novel small molecule inhibitor of hypoxia-inducible factor prolyl hydroxylase in development for the treatment of tissue damage, improved renal function and achieved cytoprotective effects in preclinical models of acute kidney injury.
	www.mrsci.com /Radiology/Radiocontrast.php (641 words)

	AHRQ WebM&M: Case & Commentary
		The incidence of CN (defined as a 25% increase in serum creatinine within 2 days of exposure) was 1.7% in the bicarbonate group vs. 13.6% in the saline group.
		A recent meta-analysis of theophylline and aminophylline concluded that these agents reduce the rise in serum creatinine following radiocontrast exposure.(15) Unfortunately, most of the theophylline and aminophylline studies did not report the fraction of subjects experiencing a discrete risk (e.g., ≥ 0.5 mg/dL increase in serum creatinine).
		An algorithm for radiocontrast use in high-risk patients should include risk assessment, avoidance of contrast exposure, determination of medical necessity, and prophylaxis (Table 2).(18,19) Low-risk patients have a low incidence of nephropathy (1% or less) and need not receive any prophylaxis.
	webmm.ahrq.gov /case.aspx?caseID=92 (2055 words)

	Pseudoallergic Reactions
		If a patient has had an anaphylactoid reaction to conventional radiocontrast media, the risk for a second reaction upon reexposure may be as high as 30%.
		The management of patients at risk for radiocontrast medium reactions includes use of the low-osmolality contrast preparations and prophylactic administration of prednisone (50 mg orally every 6 hours beginning 18 hours before the procedure) and diphenhydramine (25-50 mg intramuscularly 60 minutes before the procedure).
		The use of the lower-osmolality radiocontrast media in combination with the pretreatment regimen decreases the incidence of reactions to less than 1%.
	www.health.am /allergies/more/pseudoallergic_reactions (322 words)

	UNC Health Care — UNC Hospitals is one of first medical centers to use new device for treating life-threatening ...
		Radiocontrast dyes are used during cardiac procedures so that the flow of blood, and the locations of blockages, can be seen on a video monitor.
		Nearly half a million patients a year undergoing cardiac catheterization in the United States are considered to be at risk for RCN, including those with diabetes, renal insufficiency and congestive heart failure.
		It is believed that radiocontrast dyes can lead to RCN by constricting the renal arteries, which supply blood to the kidneys.
	www.unchealthcare.org /site/newsroom/news/2004/Oct/Benephit (633 words)

	Clinical Trial: COOL RCN: Cooling to Prevent Radiocontrast Nephropathy
		Radiographic contrast agents are administered to all patients undergoing diagnostic or interventional catheterization procedures.
		Unfortunately, the use of radiographic contrast agents is often associated with severe adverse side effects, including acute kidney failure.
		Physiologic factors that may put a patient at higher risk of developing RCN include: pre-existing renal insufficiency, diabetes mellitus, age, cardiovascular disease (particularly congestive heart failure and low ejection fraction), and dehydration or other conditions characterized by depletion of effective circulatory volume.
	clinicaltrials.gov /ct/show/NCT00306306 (839 words)

	eMedicine - Anaphylaxis : Article Excerpt by Stephen C Dreskin
		Anaphylactoid reactions to RCM were estimated to have caused 500 deaths in 1982, although this number has likely decreased because of increased awareness and the use of pretreatment regimens and/or lower osmolar agents for patients with a history of RCM reaction.
		In the United Kingdom, one half of fatal anaphylaxis episodes have an iatrogenic cause (ie, anesthesia, antibiotics, or radiocontrast), while foods and insect stings each account for a quarter of the fatal episodes.
		Other studies have shown atopy to be a risk factor for anaphylaxis from foods, exercise-induced anaphylaxis, idiopathic anaphylaxis, radiocontrast reactions, and latex reactions.
	www.emedicine.com /med/byname/Anaphylaxis.htm (1371 words)

	HDCN-- ASK THE PROFESSOR: Contrast Nephropathy
		Much has been written about radiocontrast induced nephropathy and the appropriate measures to avoid it.
		Effects of saline, mannitol, and furosemide on acute decreases in renal function induced by radiocontrast agents.
		There is at least one study on radiocontrast clearance during hemodialysis: Moon SS; Bäck SE; Kurkus J; Nilsson-Ehle P. Hemodialysis for elimination of the nonionic contrast medium iohexol after angiography in patients with impaired renal function.
	www.hdcn.com /ap/ap607con.htm (867 words)

	A Prostacyclin Analog Prevents Radiocontrast Nephropathy via Phosphorylation of Cyclic AMP Response Element Binding ... (Site not responding. Last check: 2007-11-07)
		A Prostacyclin Analog Prevents Radiocontrast Nephropathy via Phosphorylation of Cyclic AMP Response Element Binding Protein -- Yano et al.
		Lancelot E, Idee JM, Couturier V, Vazin V, Corot C: Influence of the viscosity of iodixanol on medullary and cortical blood flow in the rat kidney: a potential cause of nephrotoxicity.
		Deray G, Dubois M, Martinez F, Baumelou B, Beaufils H, Bourbouze R, Baumelou A, Jacobs C: Renal effects of radiocontrast agents in rats: a new model of acute renal failure.
	ajp.amjpathol.org /cgi/content/full/166/5/1333 (4889 words)

	[No title]
		Many important issues remain unresolved including the pathogenesis and treatment of this problem and the relative nephrotoxicity of different iodinated radiocontrast agents.
		A review of the pathogenesis and clinical characteristics of radiocontrast media-induced nephropathy is presented here.
		This variability results from differences in the presence or absence of risk factors (primarily renal insufficiency), definition of nephropathy, amount and type of agent administered, prospective or retrospective determination of incidence, and the exact radiologic procedure.
	uuhsc.utah.edu /rad/Contrastnephrotoxicity.doc (3414 words)

	UIC College of Pharmacy Drug Information Center (Site not responding. Last check: 2007-11-07)
		With the evolution of medical diagnostics within the last 50 years, the expanding use of radiocontrast agents has led to a surge of radiocontrast induced renal dysfunction as well as increased awareness about the possibility of this adverse effect.
		Generally, the risk of renal dysfunction occurring with radiocontrast agents is relatively low.
		Patients with known, but stable, chronic renal insufficiency were included in the study and were administered a nonionic low-osmolality contrast agent for diagnostic procedures as determined by their physician.
	www.uic.edu /pharmacy/services/di/nac.htm (552 words)

	Allergy & Asthma Disease Management Center: Ask the Expert
		I understand that anaphylactoid reactions to iodinated radiocontrast appear unrelated to the iodide moiety of the radiocontrast molecule and, therefore, rationally do not suggest a cross-reactivity with iodine and inorganic iodides.
		I am thinking of not just anaphylactoid reactions to iodinated radiocontrast but to delayed reactions manifesting themselves from an hour to a couple of days after radiocontrast administration.
		I am thinking that it is one thing to say the iodide moiety of the radiocontrast molecule is unrelated to anaphylactoid reactions and quite another to say it is unrelated to the delayed reactions.
	www.aaaai.org /aadmc/ate/category.asp?cat=1042&s=20&keywords= (7686 words)

	Acetylcysteine Prophylaxis for Radiocontrast Nephropathy - March 15, 2004 - American Family Physician
		Acetylcysteine Prophylaxis for Radiocontrast Nephropathy - March 15, 2004 - American Family Physician
		Radiocontrast media can reduce renal excretory function by altering renal hemodynamics or by tubulotoxic effects.
		In high-risk patients, the incidence of acute renal failure induced by radiocontrast media is estimated to be 10 to 30 percent.
	www.aafp.org /afp/20040315/tips/13.html (494 words)

	A1 adenosine receptor knockout mice are protected against acute radiocontrast nephropathy in vivo -- Lee et al. 290 ... (Site not responding. Last check: 2007-11-07)
		A1 adenosine receptor knockout mice are protected against acute radiocontrast nephropathy in vivo -- Lee et al.
		Articles by Lee, H. Articles by Kim, M. adenosine receptor knockout mice are protected against acute radiocontrast nephropathy in vivo
		AR contribute to the pathogenesis of radiocontrast nephropathy
	ajprenal.physiology.org /cgi/content/abstract/290/6/F1367 (260 words)

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