Contrast-induced nephropathy--a review of current literature and guidelines

The use of iodine-based contrast agents always entails the risk of contrast-induced nephropathy (CIN). The recently observed dramatic increase in the number of examinations and therapeutic procedures using iodine-based contrast media led us to conduct a thorough analysis of the growing number of scientific reports and collective works devoted to contrast-induced nephropathy, based on current definitions, epidemiology, pathophysiology, risk factors, successful prophylaxis and guidelines of the European Society of Urogenital Radiology (ESUR). Radiological contrast agents are the third most common cause of nephropathy among in-patients, accounting for 11-12% of cases. CIN is connected with some clinically significant consequences, including increased morbidity, prolonged hospitalisation, increased risk of complications, potential need for dialysis and increased mortality rate. A significant increase in the number of examinations applying iodine-based contrast media in the course of inpatient procedures requires close cooperation of the clinician and radiologist, supported by knowledge of all CIN issues. In order to protect patients from contrast-induced nephropathy, it is necessary to monitor their renal function, indentify patients with risk factors, refer patients for examinations in a responsible manner, and undertake successful preventive measures.