Creatinine increases after intravenous contrast administration: incidence and impact

The incidence of creatinine increases after intravenous contrast (postcontrast creatinine increases, PCCI) is controversial, ranging from 0% to >25%. We sought to determine what factors influenced these divergent estimates of PCCI incidence. Where possible, the association of PCCI with long-term adverse outcomes was also studied.

Both observational studies and prospective randomized trials were reviewed. Definitions of clinically significant PCCI, incidence of PCCI, and its association with baseline kidney function, the setting in which intravenous contrast was administered, and the short- and long-term consequences of PCCI were extracted.

Baseline renal function impairment and inpatient versus outpatient status are the major risk factors for PCCI. PCCI is possibly associated with clinically significant short- and long-term adverse events.

PCCI occurs despite a number of potential confounding issues. The incidence is increased as kidney function at baseline is diminished and for inpatients. There is limited data on long-term outcomes following PCCI in this setting.