Although the clinical features of contrast-induced
nephropathy (CIN) have been well known since many
decades, during the past 15 yr, interest among physicians on
the subject of CIN has dramatically increased.
Acute kidney injury frequently occurs in hospitalized
patients. Approximately 15% of all European in-hospital
patients develop AKI during the disease.
The prognosis has not substantially been improved in recent
years. Among exogenously administered substances that may
cause AKI, iodinated contrast media are particularly
relevant since they are extensively in use for diagnostic
purposes all over the world. They may induce intrarenal vasoconstriction and potentially exhibit toxic effects on
tubular epithelial cells in a direct manner. For many years,
preventive hydration, performed intravenously, has been the
strategy of first choice.
The exact risk for CIN is difficult to determine. In patients
with chronic kidney disease, it is well accepted that the risk
for CIN is significantly increased and rises in proportion to the
severity of underlying renal impairment. However, recent
studies on CIN in “high-risk” patients have demonstrated a
wide range of incidences.
In light of a predictable increase in CIN incidence due to
the increase in radiologic procedures, several key questions
remain for physicians who are interested in CIN. These key
questions are in the areas of pathogenesis, clinical
consequences, and effective procedural and periprocedural
prophylactic adjunctive therapies.