Contrast-induced acute kidney injury

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Contrast-induced acute kidney injury (CI-AKI, formally known as contrast nephrotoxicity, contrast-induced nephropathy (CIN),radiocontrast nephropathy (RCN), is more common in patients with pre-existing renal impairment or diabetes mellitus.[1][2]. It is associated with higher mortality, longer length of hospital stay, and additional costs[3]. Local guidelines vary, but the FCR 2015 guidance[4] mentions a eGFR of less than 40 ml/min/1.73 m2 Other risk factors include:

  • Heart failure
  • Renal transplant
  • Age - 75 years or older
  • Hypovolaemia
  • Dose of contrast or repeated administration of contrast
  • Intra-arterial administration of contrast.

Incidence

Underestimated by many. In image-guided cardiovascular procedures it is over 3%[3]

Prevention

References