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Updated: Apr 16, 2026
Murine Kidney Transplant Technique
Published on: October 20, 2015
Incidence of contrast-induced nephropathy in kidney transplant recipients
M Haider1, L Yessayan1, K K Venkat1
1Division of Nephrology and Transplantation, Henry Ford Hospital, Detroit, MI, United States.
Insights
The incidence of contrast-induced nephropathy (CIN) in kidney transplant recipients (KTRs) was low at 5.6%. This may be due to high baseline kidney function and use of hypo-osmolar contrast agents.
Area of Science:
- Nephrology
- Radiology
- Transplant Medicine
Background:
- Contrast-induced nephropathy (CIN) is a significant cause of hospital-acquired acute kidney injury (AKI).
- Risk factors for CIN are prevalent in kidney transplant recipients (KTRs), but CIN incidence data in this population is limited.
Purpose of the Study:
- To determine the incidence of CIN in kidney transplant recipients (KTRs).
- To identify factors influencing CIN development in KTRs.
Main Methods:
- Retrospective analysis of 124 KTRs receiving iodinated intravascular contrast.
- CIN defined as ≥0.5 mg/dL rise in serum creatinine or ≥25% drop in eGFR post-contrast.
- Patients had stable kidney function prior to contrast administration.
Main Results:
- CIN developed in 5.64% (7/124) of KTRs.
- Most KTRs (5/7) recovered baseline kidney function within 3 weeks; dialysis was not required.
- No significant association found between CIN incidence and diabetes, baseline creatinine, age, race, gender, ACE inhibitors, ARBs, diuretics, or hydration/N-acetylcysteine prophylaxis.
Conclusions:
- The incidence of CIN in KTRs was low (5.6%), lower than previously reported.
- High baseline eGFR (>70 mL/min/1.73 m²) and use of hypo-osmolar contrast may contribute to the low CIN rate.
- KTRs with baseline eGFR >70 mL/min have a low risk of CIN, even with concurrent calcineurin inhibitor (CNI) use.
Unlabelled:
Contrast-induced nephropathy (CIN) is responsible for one-third of acute kidney injuries (AKI) in the hospital setting. The incidence of CIN varies from 3% to 30%, depending on the preexisting risk factors, with higher incidence noted with diabetes mellitus, chronic kidney disease, and older age. Though CIN risk factors are common in kidney transplant recipients (KTRs), data about incidence of CIN in this population are sparse.
Methods:
We retrospectively analyzed 124 consecutive patients transplanted at our center between January 2002 and December 2013 and received iodinated intravascular contrast with stable kidney function prior to contrast administration. CIN was defined as either an absolute rise in serum creatinine of ≥ 0.5 mg/dL or a ≥ 25% drop in estimated glomerular filtration rate (eGFR) after contrast administration.
Results:
Seven of 124 (5.64%) patients developed CIN. Kidney function returned to baseline in 5 of the 7 patients within 3 weeks. In 2 patients serum creatinine remained elevated due to recurrent AKI episodes from other causes. Dialysis was not required in any patient. Calcineurin inhibitors (CNIs) were being used in 95% patients at the time of contrast administration. Diabetes mellitus, baseline serum creatinine, age, race, gender, and the use of ACE inhibitor, angiotensin receptor blocker, diuretic, or prophylaxis with intravenous hydration ± N-acetylcysteine did not affect the incidence of CIN.
Conclusion:
Incidence of CIN in KTRs was low in our study (5.6%), much less than previously reported. This low incidence may be related to the high baseline eGFR (>70 mL/min/1.73 m(2)) and use of hypo-osmolar contrast in our patients. In KTRs with baseline eGFR >70 mL/min, the incidence of CIN is low despite the concurrent use of nephrotoxic CNI.
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