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Contrast-induced encephalopathy in patients with advanced chronic kidney disease: What the nephrologist needs to know

Víctor Joaquín Escudero-Saiz1, Nathalie Melissa Romani2, Pastora Rodríguez3

  • 1Servicio de Nefrología y Trasplante Renal, Hospital Clínic de Barcelona, Barcelona, Spain.

Nefrologia
|June 13, 2024
PubMed

Insights

Contrast-induced encephalopathy (CIE) is a neurological complication from contrast media. Risk factors include hypertension, diabetes, and kidney disease; symptoms are non-specific, but recovery is typical within 72 hours.

Area of Science:

  • Neurology
  • Nephrology
  • Radiology

Background:

  • Contrast media used in imaging and endovascular procedures can cause neurological complications.
  • Contrast-induced encephalopathy (CIE) is a rare but significant adverse event.
  • Risk factors for CIE include pre-existing conditions and contrast properties.

Purpose of the Study:

  • To review the clinical presentation, risk factors, diagnosis, and management of contrast-induced encephalopathy.
  • To highlight the importance of awareness among nephrologists regarding CIE in patients undergoing procedures with contrast media.

Main Methods:

  • Literature review of contrast-induced encephalopathy.
  • Analysis of risk factors, clinical manifestations, diagnostic challenges, and treatment strategies.
  • Focus on the role of hemodialysis in managing CIE.

Main Results:

  • CIE symptoms are non-specific, including altered consciousness, focal deficits, and seizures.
  • Diagnosis is by exclusion, ruling out stroke; CT/MRI aid differentiation.
  • Most cases resolve within 48-72 hours, but prolonged symptoms can occur.

Conclusions:

  • Nephrologists must be aware of CIE, especially in patients on chronic hemodialysis (HD).
  • Supportive care and, in some cases, kidney replacement therapy (KRT) like HD are key treatment components.
  • Early recognition and management are crucial for patient outcomes.

Keywords:
Advanced chronic kidney diseaseContraste yodadoEncefalopatíaEncephalopathyEnfermedad renal crónica avanzadaIodinated contrast

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