The Controversy of Contrast-Induced Nephropathy With Intravenous Contrast: What Is the Risk?
Am J Kidney Dis
; 75(1): 105-113, 2020 01.
Article
in En
| MEDLINE
| ID: mdl-31473019
ABSTRACT
Contrast-induced nephropathy (CIN) has long been observed in both experimental and clinical studies. However, recent observational studies have questioned the prevalence and severity of CIN following intravenous contrast exposure. Initial studies of acute kidney injury following intravenous contrast were limited by the absence of control groups or contained control groups that did not adjust for additional acute kidney injury risk factors, including prevalent chronic kidney disease, as well as accepted prophylactic strategies. More contemporary use of propensity score-adjusted models have attempted to minimize the risk for selection bias, although bias cannot be completely eliminated without a prospective randomized trial. Based on existing data, we recommend the following CIN risk classification patients with estimated glomerular filtration rates (eGFRs) ≥ 45mL/min/1.73m2 are at negligible risk for CIN, while patients with eGFRs<30mL/min/1.73m2 are at high risk for CIN. Patients with eGFRs between 30 and 44mL/min/1.73m2 are at an intermediate risk for CIN unless diabetes mellitus is present, which would further increase the risk. In all patients at any increased risk for CIN, the risk for CIN needs to be balanced by the risk of not performing an intravenous contrast-enhanced study.
Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Contrast Media
/
Acute Kidney Injury
Type of study:
Clinical_trials
/
Etiology_studies
/
Observational_studies
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Prognostic_studies
/
Risk_factors_studies
Limits:
Humans
Language:
En
Journal:
Am J Kidney Dis
Year:
2020
Document type:
Article
Country of publication:
EEUU
/
ESTADOS UNIDOS
/
ESTADOS UNIDOS DA AMERICA
/
EUA
/
UNITED STATES
/
UNITED STATES OF AMERICA
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US
/
USA