Contrast-induced kidney injury: focus on modifiable risk factors and prophylactic strategies

Clin Cardiol. 2010 Feb;33(2):62-6. doi: 10.1002/clc.20687.

Abstract

Contrast-induced nephropathy, also known as contrast-induced acute kidney injury, is associated with rapid and often irreversible decline in kidney function following the administration of iodinated contrast agents. Contrast-induced nephropathy is the third leading cause of acute kidney injury in hospitalized patients, and substantially increases mortality, morbidity, and length of hospitalization. Contrast-induced nephropathy follows a predictable time of onset and is potentially preventable. It has been the subject of numerous studies addressing characteristics of the populations at risk and prophylactic strategies. This evidence-based review summarizes recent literature and provides a nephrologists' perspective on contrast-induced nephropathy, focusing on: the pathophysiology of contrast-induced nephropathy; identification of populations at risk; correlation between contrast-induced nephropathy and the type of contrast agent used; and finally, measures to prevent contrast-induced nephropathy, including intravenous fluids, sodium bicarbonate, N-acetylcysteine, and hemofiltration/hemodialysis.

Publication types

  • Review

MeSH terms

  • Acetylcysteine / therapeutic use
  • Acute Disease
  • Animals
  • Combined Modality Therapy
  • Contrast Media / adverse effects*
  • Cytoprotection
  • Evidence-Based Medicine
  • Fluid Therapy
  • Hemofiltration
  • Humans
  • Kidney Diseases / chemically induced
  • Kidney Diseases / physiopathology
  • Kidney Diseases / prevention & control*
  • Practice Guidelines as Topic
  • Renal Dialysis
  • Risk Assessment
  • Risk Factors
  • Sodium Bicarbonate / therapeutic use
  • Treatment Outcome

Substances

  • Contrast Media
  • Sodium Bicarbonate
  • Acetylcysteine