B. Popa 1, Monica Popiel 1, L. Gulie 1
1 Clinical Emergency Hospital Bucharest
Abstract
Contrast media-induced nephropathy (CIN) in patients receiving intraarterial iodinated contrast media is a chemotoxic adverse reaction that is often under-recognized in clinical practice due to the very low incidence of this morbidity. Th e renal impairment is usually temporary, but in a small number of patients acute renal failure can develop and dialysis may be necessary. Patients with both diabetes and pre-existing renal impairment are at the highest risk. Practices for identifying patients at risk vary: it may be possible to identify patients who may be at risk using screening questionnaires. Th e prevalence of CIN correlates with contrast media dose: therefore the amount of CM has to be minimized in all patients, especially in those with higher risk. Non-ionic monomers (low osmolar CM) are benefi cial in comparison with ionic monomers (high osmolar CM) in patients with pre-existing renal impairment. Various drugs that have been used in attempts to prevent CIN have provided contradictory results in clinical trials and therefore their eff ectiveness remains to be proven. Still, adequate hydration pre – and postangiography remains the most efficient preventive therapy.