HARRISBURG: Performing x-rays using iodine dye places patients with impaired kidney function at increased risk for kidney failure. Known as Contrast-Induced Nephropathy (ne-FROPP-a-thee) or "CIN," this complication is the third most common cause of hospital-acquired kidney failure in the United States and Europe, accounting for 10-12 percent of all such cases.

Since June 2004, the Pennsylvania Patient Safety Reporting System (PA-PSRS) has received more than 70 reports showing the negative effects the iodine dye has on patients' kidneys when administered. Patients who develop CIN have more complications, a worse prognosis, more serious long-term outcomes and prolonged hospital stays which result in increased medical costs. While less than 2 percent of patients who develop CIN require dialysis, 30 percent of these patients experience chronic kidney problems.

The Patient Safety Authority has issued a Supplementary Patient Safety Advisory along with its quarterly 2007 March Patient Safety Advisory to raise awareness of the complication which cannot be reversed, but may be prevented. A toolkit containing CIN information for facilities to raise awareness of the complication accompanies the Supplementary Advisory. The toolkit contains: a presentation with CIN information for educating clinicians; an algorithm to help providers recognize patients with risk factors for CIN; and a poster containing the pertinent CIN information to raise awareness in facilities.
"The Authority does not normally release two Advisories at the same time, but given the number of patients who could be affected by CIN we felt it warranted a separate issue," said Dr. John Clarke, clinical director of PA-PSRS. "Raising awareness of the issue is important for preventing the complication which can alter a person's life tremendously. Identifying patients who are high-risk through lab tests and other screening procedures is the first important step to prevention."

More about the risk reduction strategies for CIN can be found in the Supplementary Advisory article, "Contrast-Induced Nephropathy: Can This Iatrogenic Complication of Iodinated Contrast be Prevented?" at http://www.psa.state.pa.us/psa/lib/psa/advisories/vol1no4_supplementary_march_2007/v4_s1_suppl_advisory_mar_30_2007.pdf.

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