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Reviews in Cardiovascular Medicine (RCM) is published by IMR Press from Volume 19 Issue 1 (2018). Previous articles were published by another publisher in Open Access under a CC-BY (or CC-BY-NC-ND) licence, and they are hosted by IMR Press on imrpress.com as a courtesy and upon agreement with MedReviews, LLC.
Open Access
Review
Pathogenesis of Contrast-Induced Nephropathy: Experimental and Clinical Observations with an Emphasis on the Role of Osmolality
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1
Division of Nephrology, University of Pennsylvania School of Medicine, Philadelphia, PA
2
Department of Medicine, University of Pennsylvania School of Medicine, Philadelphia, PA
Rev. Cardiovasc. Med. 2003, 4(S5), 28–33;
Published: 20 September 2003
Abstract
Experimental studies suggest that the pathogenesis of contrast media nephrotopathy is
due to a combination of renal ischemia and direct tubular epithelial cell toxicity. Clinical
studies to date have demonstrated a reduction in clinical contrast nephropathy with the
introduction of low-osmolar and, more recently, iso-osmolar contrast media. Numerous
experimental studies have examined the role of osmolality per se in the pathogenesis of
contrast nephropathy, with conflicting results. Whether iso-osmolar contrast media are
the least nephrotoxic iodinated contrast media needs to be determined with large prospective
randomized clinical trials.
Keywords
Contrast-induced nephropathy
Osmolality
Renal medulla