Risk of acute kidney injury following intravenous iodinated contrast exposure among pediatric population: a narrative review.

Abstract

Contrast-induced acute kidney injury is a significant concern in pediatric populations following the administration of intravenous iodinated contrast media. This narrative review aims to systematically evaluate the incidence, risk factors, and diagnostic criteria associated with contrast-induced acute kidney injury in children, addressing the variability in reported rates and the implications for clinical practice. The rationale for this review stems from the need to clarify the relationship between iodinated contrast media exposure and acute kidney injury, particularly in high-risk pediatric patients, as existing literature presents inconsistent findings. A comprehensive literature search was conducted using PubMed, Scientific Direct, and Google Scholar databases, focusing on studies published between 2020 and 2025 that addressed contrast-induced acute kidney injury in children. The review identified key messages, including that contrast-induced acute kidney injury incidence ranges from 1.4-35%, influenced by factors such as chronic kidney disease, estimated glomerular filtration rates, age, and gender. The findings emphasize the need for standardized diagnostic criteria and protocols to improve the assessment and management of contrast-induced acute kidney injury in children. Additionally, there is a gap in robust randomized controlled trials, highlighting the necessity for future multicenter studies to explore novel biomarkers for early detection and effective preventive strategies. This review advocates for a balanced approach to using iodinated contrast media in pediatric patients while aiming to prevent unnecessary exclusions from vital diagnostic procedures.