Contrast-Induced Nephropathy: Current practice

Contrast induced nephropathy (CIN) is a common cause of hospital acquired acute kidney injury (AKI) and associated with adverse clinical outcomes. There is still debate regarding the exact definition, which has greatly influenced the reported incidence of CIN in literature. Recent studies have challenged the universal concern regarding risk of CIN in general population. It is found to occur more commonly after intra-arterial (IA) administration of contrast as in interventional cardiology and vascular procedures especially in patients with multiple comorbidities and underlying renal impairment. Recent studies report negligible risk after intravenous (IV) contrast administration for modern diagnostic radiological examinations. Since it is a potentially preventable clinical condition, it is imperative for health care professional to be well aware of this entity. All patients undergoing iodinated contrast exposure should be risk stratified and preventive measures should be employed in high risk population. This paper will review the epidemiology, controversies regarding definition, pathophysiology, risk stratification, iodinated contrast commonly used in practice and preventive strategies.