[Nephrotoxicity of radiographic contrast media]

The widespread use of radio-opaque contrast media continues to be a common cause of renal injury in patients admitted to hospital. Renal damage after intravascular contrast media is seen clinically as an acute reduction of glomerular filtration rate varying from a relatively transient, asymptomatic course to the development of oliguric acute renal failure. Preexisting renal insufficiency and/or other risk factors such as diabetes mellitus, dehydration, paraproteinemia, hyperuricaemia, hypoalbuminaemia, and congestive heart failure, may increase the risk of nephrotoxicity and enhance renal damage. At the Institute for Kidney Disease Zvezdara University Medical Centre, Belgrad, we observed three patients who had renal damage after intravascular contrast media during 1993. All of the patients had various risk factors, particularly baseline renal insufficiency. In order to prevent or minimize renal failure after intravascular contrast media application, the authors recommended preventive measures including identification of risk patients, minimizing contrast volume and hydration.