Define contrast-induced nephropathy.
AKI after IV administration of iodinated contrast medium
List risk factors.
Chronic kidney disease (CKD): esp. in patients with diabetes mellitus, multiple myeloma
Congestive heart failure, arterial hypotension
Nephrotoxic drugs: esp. NSAIDs
Anemia
Dehydration
Describe the course.
Creatinine is highest after 3–5 days after injury and usually falls back to the baseline level within 1 week.
The course is typically mild because end-stage renal disease usually only occurs in patients with pre-existing CKD.
Describe the prevention.
Always evaluate kidney function before administering a contrast agent.
Use a low dose and low concentration of contrast medium.
The patient should discontinue nephrotoxic substances before administration.
Ensure hydration: isotonic NaCl before and after administration of contrast medium
Acetylcysteine (no clear recommendations )
Last changed2 years ago