Contrast associated nephropathy after intravenous administration: what is the magnitude of the problem?

Abstract

Intravenous contrast media (CM) is often used in clinical practice to enhance CT scan imaging. For many years, contrast-induced nephropathy (CIN) was thought to be a common occurrence and to result in dire consequences. When treating patients with abnormal renal function, it is not unusual that clinicians postpone, cancel, or replace contrast-enhanced imaging with other, perhaps less informative tests. New studies however have challenged this paradigm and the true risk attributable to intravenous CM for the occurrence of CIN has become debatable. In this article, we review the latest relevant medical literature and aim to provide an evidence-based answer to questions surrounding the risk, outcomes, and potential mitigation strategies of CIN after intravenous CM administration.

Development and Validation of a Risk Nomogram Model for Predicting Contrast-Induced Acute Kidney Injury in Patients with Non-ST-Elevation Acute Coronary Syndrome Undergoing Primary Percutaneous Coronary Intervention

“…38,39 Moreover, the current study concluded that complications and hemodynamic instability are more associated with the development of AKI after contrast exposure than with large amounts of contrast and that reducing the amount of contrast within a certain range does not reduce the risk of CI-AKI. 8,40,41 In our study cohort, there was no statistically significant relationship between contrast dose and CI-AKI. In addition, this study was a retrospective analysis, there may be differences in the collection of patient history, and we also expect that the factors in the final prediction model are relatively simple and easy to determine.…”

An Analysis of the Prevalence and Risk Factors of Contrast-Associated Acute Kidney Injury in Patients With Diabetic Foot Ulcer

“…When entering the arterial system, moving catheters through the vessels, and interfering with lesions, plaques may rupture and release cholesterol crystals into the small renal arteries. 6,21…”

“…3,4 The majority of previous CA-AKI studies primarily involved patients undergoing coronary angiography or percutaneous coronary interventions (PCI), were conducted before the widespread use of low- and iso-osmolar CM, and did not include adequate control groups. 5,6…”

Is the combination of linagliptin and allopurinol better prophylaxis against post-contrast acute kidney injury? A multicenter prospective randomized controlled study

“…These anti-inflammatory and anti-apoptotic actions of linagliptin, when combined with the antioxidant impact of allopurinol, could result in a renoprotective effect. Lastly, the results of the present study should interrupt the long-term inertia in the field of post-contrast AKI prevention [ 24 ]. The small sample size & short period of observation in the current investigation were the major limitations of the study.…”