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Updated: May 1, 2026
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Anatomical Reconstructions of the Human Cardiac Venous System using Contrast-computed Tomography of Perfusion-fixed Specimens
Published on: April 18, 2013
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Hemodynamic and tubular changes induced by contrast media
Antonella Caiazza1, Luigi Russo1, Massimo Sabbatini1
1Department of Surgery and Nephrology, University of Naples "Federico II", Via Sergio Pansini 5, 80131 Naples, Italy.
Biomed Research International
|March 29, 2014
Summary
Contrast media can cause kidney injury (CI-AKI) through hemodynamic changes and tubular cell damage. Using low-osmolar contrast media is recommended, especially for high-risk patients, to mitigate CI-AKI risks.
Area of Science:
- Nephrology
- Radiology
- Pharmacology
Background:
- Contrast media administration is a frequent cause of acute kidney injury (AKI) in hospitalized patients.
- Contrast-induced AKI (CI-AKI) results from complex interactions affecting renal hemodynamics and tubular cell function.
- Understanding these mechanisms is crucial for preventing CI-AKI.
Purpose of the Study:
- To elucidate the pathophysiological mechanisms underlying contrast-induced acute kidney injury (CI-AKI).
- To highlight the role of contrast media properties and patient risk factors in CI-AKI development.
- To emphasize current guidelines for CI-AKI prevention.
Main Methods:
- Review of existing literature on contrast media nephrotoxicity.
- Analysis of the interplay between hemodynamic alterations and cellular damage.
- Examination of the impact of contrast media physicochemical properties.
Main Results:
- Contrast media induce intrarenal vasoconstriction, leading to ischemia and reduced glomerular filtration.
- Direct cytotoxicity causes tubular cell apoptosis, cast formation, and exacerbates ischemia.
- Renin-angiotensin system activation and reactive oxygen species (ROS) production intensify hypoxia and endothelial dysfunction.
Conclusions:
- Physiochemical properties of contrast media significantly influence CI-AKI incidence.
- Guidelines recommend iso-osmolar or low-osmolar contrast media over high-osmolar agents.
- Patient factors like age, comorbidities, and concomitant medications increase CI-AKI risk.
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