Contrast-induced nephropathy

AKI after IV administration of iodinated contrast medium

• Chronic kidney disease (CKD): esp. in patients with diabetes mellitus, multiple myeloma

• Congestive heart failure, arterial hypotension

• Nephrotoxic drugs: esp. NSAIDs

• Anemia

• Dehydration

• 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.

• 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 )