Contrast Induced Nephropathy

So for decades people have talked about Contrast Induced Nephropathy…or Contrast Induced Acute Kidney Injury – depending on the decade and location of discussion. The theory being that diuresis, increased urine viscosity and changes in vasoconstriction and vasodilation leads to a worsening of renal function following iv contrast administration.

It seems to come from the 1950’s where some patients were seen to develop acute kidney injuries following iv contrast. Now times have changed and treatments and contrasts evolved but the discussion around contrast induced nephropathy continues. At times these discussion can mean that some patients wait for scans in the Emergency Department whilst waiting for blood tests to come back first. But is this the right thing to do?

In this episode we take a look at the origins of contrast induced nephropathy, consider some recent publications on the topic and see how this translates to practice and applications of the most recent guidelines.

Reading around the topic has been hugely informative for us and we hope will be of benefit to you too!

Enjoy

Simon & Rob

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References & Further Reading

Contrast-Induced Acute Kidney Injury: Short and Long-term Complications. Weisbord. Semin Nephrol. 2011

Intravenous Contrast Material–induced Nephropathy: Causal or Coincident Phenomenon? McDonald et al. Radiology. 2013

Prophylactic hydration to protect renal function from intravascular iodinated contrast material in patients at high risk of contrast-induced nephropathy (AMACING): a prospective, randomised, phase 3, controlled, open-label, non-inferiority trial. Nijssen EC. Lancet. 2017

Acute Kidney Injury After Computed Tomography: A Meta-analysis. Aycock, Westafa. Annals Emerg Med. 2018

Royal College Radiology; Standards for intravascular contrast administration to adult patients 2015

The Internet Book of Critical Care; Contrast Induced Nephropathy, Myth Thereof

FOAMcast; Contrast Induced Nephropathy

REBEL.EM; Contrast Induced Nephropathy

LITFL; Contrast Induced Nephropathy

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