Intravenous Contrast-Induced Nephropathy—The Rise and Fall of a Threatening Idea

Autosomal dominant polycystic kidney disease and minimal trauma: medical review and case report

“…The risks of contrast-induced nephropathy in this hypovolemic patient with a single kidney were weighed against the benefits of establishing the rapid diagnosis, and he was thus rushed to CT scanning. In fact, a recently published review by Luk et al [ 22 ] emphasized that contrast-induced nephropathy risk is often overestimated and described how refraining from using contrast can cause misdiagnosis and delay in proper patient management.…”

The Controversy of Contrast-Induced Nephropathy With Intravenous Contrast: What Is the Risk?

“…However, if these predisposing AKI risk factors were present to a lesser degree in the CECT patients, this would have the biased the effect of CM in the AKI toward no difference when compared with unenhanced CT control groups. 2,79 Despite these limitations, these studies led to 2 conclusions that are valid. First, previously reported rates of AKI from intravenous CM are in general overstated.…”

“…This report was followed by additional case series of AKI after intravascular CM with excretory urography, computed tomography (CT), and noncoronary angiography. 2 In the 1980s, larger series of AKI following CM administration during coronary angiography began to appear, with CKD and DM being established as risk factors for this complication. 3 The entity of CIN was coined, most commonly in association with coronary angiography despite 90% of all intravascular CM being given intravenously during CT. Until recently it has been accepted that in high-risk patients, CM given either intra-arterially or intravenously was capable of causing AKI.…”

“…[4][5][6][7][8] During the past 10 to 15 years, an increasing number of publications have called into question whether CIN following intravenous CM administration has been overstated, exists at all, and is clinically relevant. 2,[9][10][11] These opinions arose from controlled studies demonstrating similar AKI rates in patients who underwent contrastenhanced CT (CECT) compared with those who underwent unenhanced CT. It is important to determine the true risk for nephrotoxicity following intravenous CM exposure.…”

Risco de insuficiência renal aguda pós-contraste em tomografia computadorizada: estamos atentos à função renal?

“…A Insuficiência Renal Aguda Pós-Contraste (IRA-PC) é definida como um aumento na creatinina sérica (CrS) superior a 0,5 mg/dL ou de 25% comparado ao valor basal dentro de aproximadamente 72 horas após a injeção do meio de contraste, na ausência de outras causas 1,2 . Embora geralmente breve e reversível, a IRA-PC pode acarretar doença renal crônica (DRC), necessidade de diálise, prolongamento da internação hospitalar, aumento dos custos dos serviços de saúde e até mesmo a morte 3,4 .…”