Contrast-associated acute kidney injury has multiple definitions, but is generally described as worsening renal function after administration of iodinated contrast media. It is associated with high in-hospital mortality and poor long-term survival. Furthermore, patients undergoing coronary angiography commonly have comorbidities such as hypertension or congestive heart failure, which are often treated with renin-angiotensin-aldosterone system-blocking agents such as angiotensin-converting enzyme inhibitors and angiotensin receptor blockers. Trials assessing the effects of these renin-angiotensin-aldosterone system-blocking agents on the subsequent development of contrast-associated acute kidney injury have shown conflicting data, suggesting both beneficial and harmful effects. Therefore, there are no clear guidelines on whether clinicians should discontinue renin-angiotensin-aldosterone system-blocking agents peri-procedurally. In this article, we review the data from trials assessing the effects of peri-procedural renin-angiotensin system-blocking agent use in patients undergoing coronary and peripheral angiography and intervention. Future studies will likely focus on the extent of damage or potential benefit of these agents on renal function, cardiac function, as well as morbidity and mortality. Currently, there is insufficient evidence to recommend discontinuation of angiotensin-converting enzyme inhibitors prior to coronary angiography.

造影剂相关的急性肾损伤有多种定义，但通常被描述为使用含碘造影剂后肾功能恶化。它与高住院死亡率和较差的长期生存率有关。此外，接受冠状动脉造影的患者通常有合并症，例如高血压或充血性心力衰竭，通常使用肾素-血管紧张素-醛固酮系统阻断剂治疗，例如血管紧张素转换酶抑制剂和血管紧张素受体阻滞剂。评估这些肾素-血管紧张素-醛固酮系统阻断剂对造影剂相关急性肾损伤的后续发展影响的试验显示出相互矛盾的数据，表明有益和有害的影响。所以，关于临床医生是否应在围手术期停用肾素-血管紧张素-醛固酮系统阻滞剂尚无明确指南。在本文中，我们回顾了评估围手术期使用肾素-血管紧张素系统阻滞剂对接受冠状动脉和外周血管造影和介入治疗的患者的影响的试验数据。未来的研究可能会集中在这些药物对肾功能、心脏功能以及发病率和死亡率的损害程度或潜在益处上。目前，没有足够的证据建议在冠状动脉造影前停用血管紧张素转换酶抑制剂。我们回顾了评估围手术期使用肾素-血管紧张素系统阻滞剂对接受冠状动脉和外周血管造影和介入治疗的患者的影响的试验数据。未来的研究可能会集中在这些药物对肾功能、心脏功能以及发病率和死亡率的损害程度或潜在益处上。目前，没有足够的证据建议在冠状动脉造影前停用血管紧张素转换酶抑制剂。我们回顾了评估围手术期使用肾素-血管紧张素系统阻滞剂对接受冠状动脉和外周血管造影和介入治疗的患者的影响的试验数据。未来的研究可能会集中在这些药物对肾功能、心脏功能以及发病率和死亡率的损害程度或潜在益处上。目前，没有足够的证据建议在冠状动脉造影前停用血管紧张素转换酶抑制剂。