Contrast-induced nephropathy risk factors

Contrast-induced nephropathy has been defined as an increase in serum creatinine of at least 25% or an absolute increase in serum creatinine of at least 0.5 mg/dL within 48 to 72 hours of iodinated contrast administration and is associated with significant morbidity and mortality (75). Important risk factors include diabetes mellitus, chronic renal insufficiency, administration of large volumes of high osmolar contrast agents, and intravascular volume depletion. Numerous pharmacologic preventive measures have been studied, but consistent benefits have not been demonstrated. In a recent large retrospective study, preprocedural statin therapy was independently associated with a lower risk of contrast nephropathy and nephropathy requiring dialysis (76). 

Contrast-induced nephropathy (CIN) is the most serious complication associated with the use of CM and can negatively affect long-term patient morbidity and mortality (4-10). CIN is usually defined as an acute decline in renal function characterized by an absolute rise of 0.5mg/dl (44jumol/l) in serum creatinine (SCr) or a 25% increase from baseline, occurring after the systemic administration of CM in the absence of other risk factors such as atheroembolic disease, hypotension and lew blood volume, surgery, or nephrotoxins (1,2,6,7,10-13). 

I 8 Goldenberg I, Matetzky S. Nephropathy induced by contrast media pathogenesis, risk factors and preventive strategies. CMAJ 2005 172 1461-1471. 

Table 1. Risk factors for contrast media-induced nephropathy.

Nephrotoxicity induced by radiographic contrast media is the third leading cause of hospital-acquired acute renal failure.The incidence rises from <2% in patients with low risk to 40% to 50% in high-risk patients such as those with pre-existent renal insufficiency or diabetes melhtus. " " The risk of contrast nephropathy increases as the number of risk factors increases, and diabetic patients with renal insufficiency have the greatest risk." " ... 

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