Related Experiment Video
Updated: Mar 22, 2026
Anatomical Reconstructions of the Human Cardiac Venous System using Contrast-computed Tomography of Perfusion-fixed Specimens
Published on: April 18, 2013
A Retrospective Review of Contrast Nephropathy in a General Population
Insights
Contrast-induced nephropathy incidence may be overestimated in patients undergoing CT scans. Most cases with elevated creatinine had other contributing risk factors besides contrast media exposure.
Area of Science:
- Nephrology
- Radiology
- Medical Imaging
Background:
- Contrast-induced nephropathy (CIN) is a known adverse event of intravenous (IV) contrast media.
- The actual incidence of CIN remains poorly characterized, particularly in patients with pre-existing renal impairment.
Purpose of the Study:
- To investigate the incidence of CIN in patients with elevated baseline serum creatinine undergoing computed tomography (CT) with IV contrast.
- To identify other risk factors contributing to elevated serum creatinine in these patients.
Main Methods:
- Retrospective analysis of electronic medical records from a community hospital.
- Identified patients with elevated baseline serum creatinine ( > 1.2 mg/dL) who underwent CT with IV contrast media.
- Assessed for subsequent rise in serum creatinine and identified concomitant risk factors.
Main Results:
- 193 patients with elevated baseline creatinine underwent 236 CT studies.
- Nine patients (4.7%) experienced a rise in serum creatinine (≥ 0.5 mg/dL) within one month.
- None of these nine patients had contrast media exposure as the sole risk factor for elevated creatinine.
Conclusions:
- The contribution of IV contrast media to nephropathy may be overestimated.
- Further research is needed to determine if CIN is a common or distinct entity in patients without other risk factors.
- Routine pretreatment for CIN may not be warranted in all cases, considering risks and costs.
Background:
One of the adverse events associated with administration of intravenous (IV) contrast media is contrast-induced nephropathy, yet its incidence is poorly characterized. We investigated the incidence of contrast-induced nephropathy in patients with elevated baseline serum creatinine concentrations who underwent computed tomography (CT) using IV contrast media.
Materials And Methods:
Using the electronic medical records at a community hospital, we retrospectively identified patients with elevated baseline serum creatinine concentrations who had undergone CT utilizing IV contrast media between January and July 2000, a period prior to the routine use of pretreatment as prophylaxis against contrast-induced nephropathy, and who subsequently developed elevated serum creatinine. We identified concomitant risk factors for the rise in serum creatinine in these patients aside from IV contrast media exposure.
Results:
One hundred ninety-three patients with a baseline serum creatinine concentration greater than 1.2 mg/dL underwent 236 CT studies utilizing IV low-osmolar contrast media. Nine of the 193 patients had a rise in serum creatinine ≥ 0.5 mg/dL up to 1 month later. None of these 9 patients had contrast exposure as the only risk factor for their rise in serum creatinine.
Conclusion:
The role of IV contrast media in causing contrast-induced nephropathy and, thus, acute kidney injury, may be overestimated. Further study needs to be done into whether contrast-induced nephropathy is truly a common or even a real entity in patients receiving IV contrast media for routine studies who have no other risk factors for kidney injury warranting the expense, risks, and inconvenience of pretreatment.
Related Concept Videos
01:30Acute Kidney Injury IV: Diagnostic Studies and Prevention
01:06Renal Drug Clearance: Overview
Renal clearance can be calculated using different methods. One approach is to divide the urinary drug excretion rate by the plasma drug concentration. This method directly measures renal clearance, indicating the kidneys' efficiency in...
01:15Renal Drug Excretion: Overview
A nephron consists of two primary structures: the renal corpuscle and the renal tubule. The renal corpuscle contains the glomerulus, a network of capillaries where the first step of renal excretion, glomerular filtration, occurs. Blood pressure forces water, ions, and small molecules...
01:18Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Excretion
01:29Acute Kidney Injury III: Clinical Manifestations
01:25Drug Dosing in Renal Diseases: Dose Adjustments Based on Drug Clearance and Elimination Rate Constant