Contrast induced nephropathy: what's the true risk?
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Iodinated IV contrast has long been considered a significant contributor to acute kidney injury in hospitalized patients. But so-called contrast induced nephropathy is hard to accurately identify in real clinical circumstances. Acute kidney injury (AKI) can happen from a variety of causes, or their combination, during acute illness. And no randomized trial has established the risk of contrast induced nephropathy. Further, most of the literature reporting AKI after IV contrast was done in an earlier era, when IV contrast agents were hyperosmolar. Newer contrast agents are generally low- or iso-osmolar, and friendlier to the kidneys. If the risk for contrast induced nephropathy is overblown, it could be detrimental to patient care. Tests and treatments requiring intravenous contrast are often deferred in patients with elevated creatinine who need a diagnosis for suspected pulmonary embolism, arterial thrombus, or intra-abdominal catastrophes. The diagnostic gap leaves their doctors with less than the best information to make treatment decisions. An increasing body of research is calling into question the risks to kidneys from IV iodinated contrast, including a study in the
Contrast induced nephropathy: what's the true risk?
Contrast induced nephropathy: what's the true…
Contrast induced nephropathy: what's the true risk?
Iodinated IV contrast has long been considered a significant contributor to acute kidney injury in hospitalized patients. But so-called contrast induced nephropathy is hard to accurately identify in real clinical circumstances. Acute kidney injury (AKI) can happen from a variety of causes, or their combination, during acute illness. And no randomized trial has established the risk of contrast induced nephropathy. Further, most of the literature reporting AKI after IV contrast was done in an earlier era, when IV contrast agents were hyperosmolar. Newer contrast agents are generally low- or iso-osmolar, and friendlier to the kidneys. If the risk for contrast induced nephropathy is overblown, it could be detrimental to patient care. Tests and treatments requiring intravenous contrast are often deferred in patients with elevated creatinine who need a diagnosis for suspected pulmonary embolism, arterial thrombus, or intra-abdominal catastrophes. The diagnostic gap leaves their doctors with less than the best information to make treatment decisions. An increasing body of research is calling into question the risks to kidneys from IV iodinated contrast, including a study in the