Risk of Contrast Induced Nephropathy With Intravenous Administration

Abstract

ABSTRACT:With the increasing use of iodinated contrast media for CT Scan and other radiologic procedures, contrast induced nephropathy (CIN) has emerged as an important delayed adverse effect due the intravascular administration of contrast media. OBJECTIVES: To study the incidence of CIN in patients undergoing intravenous contrast enhanced CT (CECT) scans and to assess the safety of iodinated, low osmolar contrast media (LOCM) in such patients. MATERIALS AND METHODS: We conducted a study in 182 patients who received intravenous low osmolar contrast media to assess the risk of CIN in patients undergoing diagnostic CECT. All the patients had a baseline serum creatinine (SeCr) value done prior to the procedure, and were then followed up with a repeat SeCr at 48 to 72hrs, and where necessary, on day 5 to 7 after the procedure. RESULTS: Thirty eight patients (20.9%) showed no change in their baseline SeCr value at 48 hrs. after contrast administration, while 13 patients (7.1%) showed a slight decrease, and 131 patients (72%) showed an increase in SeCr. None of the patients showed a greater than 0.5mg/dL increase in the SeCr, while 3 patients (1.6%) showed a 25% increase in the 48 hrs. SeCr from baseline value. CONCLUSION: The incidence of CIN varied from 0 to 1.6% depending on the definition used. Contrast induced nephropathy is a rare complication of intravenous administration of contrast media. LOCMs can be safely used in the general population who do not have pre-existing renal impairment or other major risk factors.