zabmedvestnikЗабайкальский медицинский вестникTransbaikalian Medical Bulletin1998-6173Читинская государственная медицинская академия10.52485/19986173_2026_1_152zabmedvestnik-511Research ArticleНАУЧНЫЕ ОБЗОРЫSCIENTIFIC REVIEWSСовременное состояние проблемы контраст-индуцированного острого повреждения почекThe current state of the problem of contrast-induced acute kidney injuryhttps://orcid.org/0000-0003-3243-2951МишкоМ. Ю.MishkoM. Yu.

Марина Юрьевна Мишко, к. м. н., ассистент

педиатрический и стоматологический факультеты; кафедра внутренних болезней

672000; ул. Горького, 39а; 672040; ул. Горбунова, 11, корпус 1; Чита

Researcher ID WoS: A-7972-2018, Author ID РИНЦ: 845528, Author ID Scopus: 57201845900

Candidate of Medical Sciences, Assistant

Pediatric and Dental Faculties; Department of Internal Diseases

672000; 39a Gorky St.; 672040; 11 Gorbunova st., building 1; Chita

Researcher ID WoS: A-7972-2018, Author ID RSCI: 845528, Author ID Scopus: 57201845900

mm_you@mail.ruhttps://orcid.org/0000-0001-8410-5827МедведеваТ. А.MedvedevaT. A.

Татьяна Александровна Медведева, к. м. н., врач-кардиолог

отделение сердечно-сосудистой хирургии

108814; ул. Сосненский стан, дом 8, стр. 11; Москва

Author ID РИНЦ: 691739, Author ID Scopus: 57200387424

Candidate of Medical Sciences, cardiologist

Department of Cardiovascular Surgery

108814; 8 Sosnensky Stan st., building 11; Moscow

Author ID RSCI: 691739, Author ID Scopus: 57200387424

saidi-tma@mail.ruhttps://orcid.org/0000-0002-0350-0698ПавловаН. Н.PavlovaN. N.

Наталья Николаевна Павлова, д. м. н., профессор, заведующая кафедрой

педиатрический и стоматологический факультеты; кафедра внутренних болезней

672000; ул. Горького, 39а; 672040; ул. Горбунова, 11, корпус 1; Чита

Researcher ID WoS: D-6608-2018, Author ID РИНЦ: 691741, Author ID Scopus: 55322055900

Doctor of Medical Sciences, Professor, Head of the Department

Pediatric and Dental Faculties; Department of Internal Diseases

672000; 39a Gorky St.; 672040; 11 Gorbunova st., building 1; Chita

Researcher ID WoS: D-6608-2018, Author ID RSCI: 691741, Author ID Scopus: 55322055900

natalia.kushnarenko1@gmail.comhttps://orcid.org/0000-0002-0487-6275КараваеваТ. М.KaravaevaT. M.

Татьяна Михайловна Караваева, к. м. н., доцент, старший научный сотрудник, доцент кафедры

НИИ молекулярной медицины; лаборатория клинической и экспериментальной биохимии и иммунологии; кафедра химии и биохимии

672000; ул. Горького, 39а; Чита

Researcher ID WoS: AAA-6947-2020, Author ID РИНЦ: 5483-1547, Author ID Scopus: 57210698292

Candidate of Medical Sciences, Associate Professor, Senior Researcher, Assistant Professor 

Research Institute of Molecular Medicine; Laboratory of Clinical and Experimental Biochemistry and Immunology; Department of Chemistry and Biochemistry

672000; 39a Gorky St.; Chita

Researcher ID WoS: AAA-6947-2020, Author ID RSCI: 5483-1547, Author ID Scopus: 57210698292

KaTany1@yandex.ruhttps://orcid.org/0000-0003-2109-4643МиромановаН. А.MiromanovaN. A.

Наталья Анатольевна Мироманова, д. м. н., доцент, заведующая кафедрой

кафедра детских инфекций

672000; ул. Горького, 39а; Чита

Author ID РИНЦ: 585748, Author ID Scopus: 34971682200

Doctor of Medical Sciences, Associate Professor, Head of the Department

Department of Children's Infections

672000; 39a Gorky St.; Chita

Author ID RSCI: 585748, Author ID Scopus: 34971682200

detinf-chita@mail.ruhttps://orcid.org/0009-0009-7619-3519СтарицынаЕ. В.StaritsynaE. V.

Елена Владимировна Старицына, заведующая отделением

нефрологическое отделение

672040; ул. Горбунова, 11, корпус 1; Чита

Author ID РИНЦ: 1275307

Head of the Departament

Nephrology Departament

672040; 11 Gorbunova st., building 1; Chita

Author ID RSCI: 1275307

elena-staritsyna@mail.ruФГБОУ ВО «Читинская государственная медицинская академия» Министерства здравоохранения РФ; Частное учреждение здравоохранения «Клиническая больница «РЖД-Медицина» г. Чита»РоссияChita State Medical Academy; Russian Railways-Medicine Clinical Hospital "RZhD-Medicine"Russian FederationМосковский многопрофильный клинический центр «Коммунарка»РоссияMoscow Multidisciplinary Clinical Center "Kommunarka"Russian FederationФГБОУ ВО «Читинская государственная медицинская академия» Министерства здравоохранения РФРоссияChita State Medical AcademyRussian FederationЧастное учреждение здравоохранения «Клиническая больница «РЖД-Медицина» г. Чита»РоссияRussian Railways-Medicine Clinical Hospital "RZhD-Medicine"Russian Federation20261905202601152173Copyright © Мишко М.Ю., Медведева Т.А., Павлова Н.Н., Караваева Т.М., Мироманова Н.А., Старицына Е.В., 20262026Мишко М.Ю., Медведева Т.А., Павлова Н.Н., Караваева Т.М., Мироманова Н.А., Старицына Е.В.Mishko M.Y., Medvedeva T.A., Pavlova N.N., Karavaeva T.M., Miromanova N.A., Staritsyna E.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.zabmedvestnik.ru/jour/article/view/511

   Контраст-индуцированная нефропатия (КИН) представляет собой серьезную ятрогенную проблему современной медицины, возникающую после парентерального введения рентгеноконтрастных средств. Данное осложнение обладает значимым негативным прогнозом, ассоциируясь с ростом кардиоваскулярной и неврологической заболеваемости, повышением показателей летальности, удлинением сроков госпитализации и, как следствие, увеличением финансовой нагрузки на систему здравоохранения. Наибольшая распространенность КИН наблюдается в когорте пациентов, имеющих исходно заболевания почек или снижение скорости клубочковой фильтрации, обусловленное другими причинами. Сочетание нескольких предрасполагающих факторов приводит к их кумулятивному эффекту и многократному возрастанию вероятности развития нефропатии.

   Ключевым элементом в борьбе с КИН считается своевременная стратификация риска и внедрение превентивных мер.

   Наиболее доказанной и широко применяемой стратегией профилактики остается адекватная внутривенная гидратация изотоническим раствором натрия хлорида. Эффективность же применения с этой целью ряда фармакологических средств остается предметом научных дискуссий и не имеет однозначного подтверждения. Настоящее исследование посвящено комплексному рассмотрению этиологии и патогенеза острого почечного повреждения, индуцированного введением контрастных средств. В статье систематизируются основные факторы риска развития данного осложнения, детально разбираются патофизиологические механизмы его возникновения, а также оценивается эффективность современных диагностических алгоритмов и превентивных мер.

   Contrast-induced nephropathy (CIN) is a serious iatrogenic problem of modern medicine that occurs after parenteral administration of radiopaque agents. This complication has a significant negative prognosis, associated with an increase in cardiovascular and neurological morbidity, an increase in mortality rates, an extension of hospitalization and, as a result, an increase in the financial burden on the healthcare system. The highest incidence of CIN is observed in the cohort of patients with baseline renal disease or decreased glomerular filtration rate due to other reasons. The combination of several predisposing factors leads to their cumulative effect and a multiple increase in the likelihood of developing nephropathy. Timely risk stratification and implementation of preventive measures are considered key element in the fight against CIN. Adequate intravenous hydration with isotonic sodium chloride remains the most proven and widely used prevention strategy. The effectiveness of the use of a number of pharmacological agents for thispurpose remains the subject of scientific debate and has no unambiguous confirmation.

   This study focuses on the etiology and pathogenesis of contrast-induced acute renal injury.

   The article systematizes the main risk factors for the development of this complication, analyzes in detail the pathophysiological mechanisms of its occurrence, and also evaluates the effectiveness of modern diagnostic algorithms and preventive measures.

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The authors declare that there are no conflicts of interest present.