Contrast-Induced Nephropathy

Excerpt

There is a lack of consensus on the definition and treatment of contrast-induced nephropathy (CIN). Currently, the understanding of CIN is that it is the impairment of renal function gauged as either a 25% rise in serum creatinine from baseline or an increase of 0.5 mg/dL (44 µmol/L) in absolute serum creatinine value within 48-72 hours following intravenous contrast administration.

The renal impairment that is linked with the administration of contrast is acute, usually occurring within 2-3 days. However, it has been recommended that renal impairment developing up to seven days post-contrast administration should be considered CIN if it is not attributable to any other possible cause of kidney failure. A temporal link is thus implied. Post-contrast exposure, serum creatinine levels peak between two and five days and usually return to baseline in 14 days.

Iodine contrast medium is essential in invasive and interventional cardiac procedures. Because of an increasing number of coronary angiography and coronary interventional procedures, the increasing use of contrast media, and the increasing number of invasive cardiac procedures being performed in high-risk patients with chronic kidney disease, diabetes mellitus, hypertension, and kidney failure due to contrast-induced nephropathy remains a growing concern. A sudden change in kidney function is a common complication of coronary angiography, and percutaneous coronary intervention, primarily because of contrast-induced acute kidney injury or contrast-induced nephropathy.