Prevention of Contrast-Induced Nephropathy (CIN) in Interventional Radiology Practice

Rajan K Gupta; Tami J Bang

doi:10.1055/s-0030-1267860

Seminars in Interventional Radiology, Table of Contents

Semin intervent Radiol 2010; 27(4): 348-359
DOI: 10.1055/s-0030-1267860

Prevention of Contrast-Induced Nephropathy (CIN) in Interventional Radiology Practice

Rajan K. Gupta¹ , Tami J. Bang¹

¹Department of Radiology, Division of Interventional Radiology, University of Colorado, Aurora, Colorado

Abstract

ABSTRACT

Contrast-induced nephropathy (CIN) is a widely recognized and clinically significant problem in patients undergoing an increasing number of minimally invasive procedures that require contrast administration. Contrast-induced nephropathy is the third most common cause of hospital-acquired renal failure and has significant prognostic implications on patient outcomes. Interventional practitioners are faced with challenging decisions regarding prophylaxis and patient management. The major risk factor for developing CIN is preexisting renal dysfunction, particularly in association with diabetes. Patients are considered to be at risk when estimated glomerular filtration rate (eGFR) or estimated creatinine clearance (eC_Cr) is less than 60. The cornerstone of prevention of CIN is appropriate risk stratification, intravenous hydration with normal saline or sodium bicarbonate, appropriate withholding of nephrotoxic medications, use of low or iso-osmolar contrast media, and various intraprocedural methods for iodinated contrast dose reduction. Although N-acetylcysteine administration is popular, it remains unproven. Practitioners must be familiar with prevention strategies and diagnosis of CIN to minimize its clinical impact.

KEYWORDS

Contrast-induced nephropathy - CIN - renal failure - contrast media - prevention

Full Text

References

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Rajan GuptaM.D.

Assistant Professor of Radiology, Department of Radiology, Division of Interventional Radiology, University of Colorado

Mailstop L954, 12401 East 17th Avenue, Room 538, Aurora, CO 80045

Email: Rajan.Gupta@ucdenver.edu