Contrast-Induced Acute Kidney Injury: Is There a Risk after Intravenous Contrast?

[摘要] Contrast-induced nephropathy (CIN) is a form of acute kidney injury (AKI) that follows exposure to intravascular contrast media. Its pathogenesis involves renal ischemia, particularly in the outer medulla, where oxygen delivery is already at critical levels, and direct epithelial cell toxicity. There is no consensus regarding the definition of CIN. Changes in serum creatinine (a marker of glomerular filtration rather than injury) are the most widely used, but different definitions (e.g., ≥0.5 mg/dl or ≥25% increase) are often used in clinical trials. These definitions have been validated as surrogate markers because those who experience changes of this magnitude have a significant increase in short- and long-term morbidity and mortality. This association between CIN and long-term adverse outcomes has been best demonstrated by retrospective analyses of cardiac angiography cohorts (1–3); however, 90% of contrast media are used for computed tomography (CT) imaging, and patients who undergo contrast-enhanced CT may differ significantly from those who undergo angiography.

[学科分类] 泌尿医学

[关键词] Bone marrow necrosis;Sickle cell disease;Hyperhemolysis syndrome