Interv Akut Kardiol. 2002;1(1):37-40

Damage to the kidneys caused by contrast agents

Vojtěch Martínek

Interní klinika fakultní nemocnice Motol a 2. lékařské fakulty Univerzity Karlovy v Praze

Nephropathy due to the application of radio-contrast agents, called contrast nephropathy (CN), is determined by the development of acute renal failure or by the progression of pre-existing renal insufficiency within 24–72 hours after contrast agent administration. Serum creatinine usually rises 30 % above its previous level. In pathogenesis of CN relative hypoperfusion of renal medulla results in its subsequent ischemic injury. In majority of cases the diuresis continues and the decrease of renal function is reversible.

The incidence of CN in patients with normal renal function is very low, but increases with the severity of the pre-existing renal insufficiency and can reach even 40%. Patients with diabetic nephropathy and patients with reduced effectively circulating volume are exposed to an extraordinary high risk.

Sufficient hydration is a cornerstone in prevention of CN. High risk patients should recieve 0,45 % solution of NaCl at 1ml/kg/hour intravenously, 12 hours prior and after contrast administration. In patients with a severe renal insufficiency (mainly due to diabetic nephropathy) low-osmolar contrast agent should be used, maybe with consequent haemodialysis.

Keywords: contrast media, contrast nephropathy, acute renal failure.

Published: December 31, 2002  Show citation