Preventing Contrast-induced Renal Failure: A Guide

Abstract

Contrast-induced acute kidney injury (CI-AKI) is characterised by a rapid deterioration of renal function within a few days of parenteral administration of contrast media (CM) in the absence of alternative causes. CI-AKI is the most common form of iatrogenic kidney dysfunction with an estimated prevalence of 12 % in patients undergoing percutaneous coronary intervention. Although usually self-resolving, in patients with pre-existing chronic kidney disease (CKD) or concomitant risk factors for renal damage, CI-AKI is associated with increased short-and long-term morbidity and mortality. Therefore, risk stratification based on clinical and peri-procedural characteristics is crucial in selecting patients at risk of CI-AKI who would benefit the most from implementation of preventive measures.

Keywords: Contrast-induced nephropathy; chronic kidney disease; prevention; risk score.

Conflict of interest statement

Conflicts of Interest: MF has no disclosures. RM has received research grant support form Eli Lilly/DSI, BMS; AstraZeneca, The Medicines Company, OrbusNeich, Bayer and CSL Behring. She has worked as a consultant for Janssen Pharmaceuticals, Inc., Osprey Medical Inc., Watermark Research Partners and Medscape. She is on the advisory board of Abbott Laboratories. She has equity in Claret Medical Inc., Elixir Medical Corporation. She has given industry sponsored lectures (without any marketing purpose) for PlatformQ, Sanofi-aventis, other activities comprise but are not limited to, committee participation, data safety monitoring board (DSMB) membership for Covidien and Forest Laboratories (no payment).

Figures

Figure 1:. Flowchart of Patient Risk Assessment and Management for Contrast-induced Acute Kidney Injury