Strategies to reduce the risk of contrast nephropathy: an evidence-based approach
Bibliographic record
Abstract
PURPOSE OF REVIEW: Contrast nephropathy is a common complication associated with angiographic procedures that carries significant morbidity and mortality. Recent clinical trials of prophylactic strategies have reported contradictory results. This review presents recent insights into the pathophysiology of contrast nephropathy and reviews trial results in this context. RECENT FINDINGS: A prediction rule has been developed to better identify patients at risk of developing contrast nephropathy. Factors other than osmolality play a significant role in the pathogenesis of contrast nephropathy, at least for agents with osmolalities of 800 mOsm/kg or less. New randomized trial data do not support a role for N-acetylcysteine in contrast nephropathy prophylaxis and there is additional evidence that fenoldopam is ineffective. Pooled analyses of theophylline prophylaxis trials are inconclusive. Theoretical and clinical data suggest that ascorbic acid may be renoprotective, but this requires further study. SUMMARY: The overall incidence of contrast nephropathy remains low. Available evidence supports the use of hydration and low volumes of iso-osmolar or low-osmolar contrast in patients at risk of developing contrast nephropathy. Heterogeneity has affected interpretability of interventional trials of N-acetylcysteine or theophylline prophylaxis strategies. Future clinical trials must identify and target moderate-risk to high-risk patients and ensure that proven therapies are included in trial protocols.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.004 | 0.009 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.007 | 0.002 |
| Bibliometrics | 0.006 | 0.004 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.002 | 0.003 |
| Open science | 0.003 | 0.001 |
| Research integrity | 0.004 | 0.002 |
| Insufficient payload (model declined to judge) | 0.007 | 0.002 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".