Contrast-Induced Nephropathy: An Overview

Abstract

Background This review elaborates on the definition, incidence, risk factors and treatment options for contrast-induced acute renal injury and highlights the potential therapeutic options to prevent this condition. Contrast-induced nephropathy is a subclinical and acute form of renal failure characterized by an unexplained worsening of renal function within 48–72 h after the administration of iodinated contrast media. Methods A PubMed search was performed to identify studies published in English and focused on contrast-induced nephropathy using specific keywords:: contrast-induced nephropathy, acute renal failure, iodinated contrast agent, chronic renal failure, and percutaneous coronary intervention. Results The risk of developing contrast-induced nephropathy increases in the presence of certain factors, including pre-existing renal dysfunction, diabetes, congestive heart failure, advanced age, and the concomitant use of nephrotoxic drugs; this risk varies from 5% in patients with mild renal dysfunction to 50% in patients with diabetes and severe renal dysfunction. Conclusions Over recent years, many patients undergoing percutaneous coronary intervention, do not opt to receive iodinated contrast agents due to the risk of acute renal failure, thus compromising diagnostic procedures. However, recent studies have shown that contrast-induced nephropathy occurs less frequently in patients with normal renal function than in those with pre-existing chronic renal failure and/or diabetes mellitus. Furthermore, over recent years, preventive strategies using intravenous fluids, pharmaceuticals, and renal replacement therapy, have reduced the occurrence of contrast-induced nephropathy. However, as diagnostic and therapeutic intervention paradigms evolve, some questions remain unanswered.