[Nephrotoxicity of contrast media--etiopathogenesis and methods of prevention]

Contrast-induced nephropathy remains one of the most serious adverse event of contrast imaging. Patients with existing renal impairment, with or without diabetes, those with congestive heart failure or myeloma, and patients who receive nonsteroidal antiinflammatory drugs may be at higher risk. The pathogenesis of contrast-induced nephrotoxicity probably involves renal ischemic injury, tubular obstruction and direct tubular toxicity. Some prophylactic procedures based on these pathogenetic hypotheses have been proposed. Up-to-date knowledge on incidence, pathogenesis, risk factors, preventive procedures and therapeutic approaches of radiocontrast nephropathy is reviewed.