Abstract
A sudden drop in renal function after exposure to contrast media was first described more than 60 years ago. Contrast medium-induced nephropathy (CIN) is still considered an important acute adverse reaction. Despite both clinical and experimental research, its pathophysiology is still unclear. It occurs to the same extent after all non-ionic iodine-based contrast agents. Patients at increased risk are those with moderately and severely reduced renal function. Volume expansion seems to reduce the frequency, but no pharmacological manipulation has been proven to be helpful. This chapter reviews the recent information on CIN.
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References
Alamartine E, Phayphet M, Thibaudin D et al (2003) Contrast medium-induced acute renal failure and cholesterol embolism after radiological procedures: incidence, risk factors, and compliance with recommendations. Eur J Intern Med 14:426–431
Allaqaband S, Tumuluri R, Malik AM et al (2002) Prospective randomized study of N-acetylcysteine, fenoldopam and saline for prevention of radiocontrast-induced nephropathy. Catheter Cardiovasc Intervent 57:279–283
Almen T, Frennby B, Sterner G (1999) Determination of glomerular filtration rate (GFR) with contrast media. In: Thomsen HS, Muller RN, Mattrey RF (eds) Trends in contrast media. Springer, Berlin, pp 81–94
Alonso A, Lau J, Jaber BL et al (2004) Prevention of contrast nephropathy with N-acetylcysteine in patients with chronic kidney disease: a meta-analysis of randomized controlled trials. Am J Kidney Dis 43:1–9
Andrew E, Berg KJ (2004) Nephrotoxic effects of X-ray contrast media. J Toxicol Clin Toxicol 42:325–332
Asif A, Epstein M (2004) Prevention of radiocontrast-induced nephropathy. Am J Kidney Dis 44:12–24
Aspelin P, Aubry P, Fransson S-G et al (2003) Nephrotoxic effects in high-risk patients undergoing angiography. N Engl J Med 348:491–499
Bader BD, Berger ED, Heede MB et al (2004) What is the best hydration regimen to prevent contrast media-induced nephrotoxicity? Clin Nephrol 62:1–7
Bagshaw SM, Ghali WA (2004) Acetylcysteine for prevention of contrast induced nephropathy after intravascular angiography: a systematic review and meta-analysis. BMC Med 2:38
Bagshaw SM, Ghali WM (2005) Theophylline for prevention of radiocontrast nephropathy: a systematic review and meta-analysis. Arch Intern Med 176:1087–1093
Bagshaw SM, McAlister FA, Manns BJ, Gahli WA (2006) Acetylcysteine in the prevention of contrast-induced nephropathy. Arch Intern Med 166:161–166
Bailey CJ, Turner RC (1996) Metformin. New Engl J Med 334:574–579
Balemans CE, Reichert IJ, van Scheven BI et al (2012) Epidemiology of contrast material induced nephropathy in the era of hydration. Radiology 263:706–713
Band RA, Gaieski DF, Mills AM et al (2007) Discordance between serum creatinine and creatinine clearance for identification of ED patients with abdominal pain at risk for contrast induced nephropathy. Am J Emerg Med 25:268–272
Barrett BJ, Parfrey PS (2006) Preventing nephropathy induced by contrast medium. N Engl J Med 354:379–386
Barrett BJ, Katzberg RW, Thomsen HS et al (2006) Contrast induced nephropathy in patients with chronic kidney disease undergoing computed tomography: a double blind comparison of iodixanol and iopamidol. Invest Radiol 41:815–821
Bartels ED, Brun GC, Gammeltoft A, Gjørup PA (1954) Acute anuria following intravenous pyelography in a patient with myelomatosis. Acta Med Scand 40:297–302
Bartholomew BA, Harjai KJ, Dukkipati S et al (2004) Impact of nephropathy after percutaneous coronary intervention and a method for risk stratification. Am J Cardiol 93:1515–1519
Becker J, Babb J, Serrano M (2013) Glomerular filtration rate in evaluation of the effect of iodinated contrast media on renal function. AJR Am J Roentgenol 200:822–826
Benigni A, Remuzzi G (1999) Endothelin antagonists. Lancet 353:133–138
Berns AS (1989) Nephrotoxicity of contrast media. Kidney Int 36:730–740
Bellomo R, Ronco C, Kellum JA et al (2004) Acute dialysis quality initiative workgroup: acute renal failure: definition, outcome measures, animal models, fluid therapy and information technology needs. the second international consensus conferences of the acute dialysis quality initiative (ADQI) group. Crit Care 8:R204–R212
Bettmann MA (2005) Contrast medium-induced nephropathy: critical review of the existing clinical evidence. Nephrol Dial Transplant 20(Suppl 1):i12–i17
Biondi-Zoccai GG, Lotrionte M, Abbate A et al (2006) Compliance with QUOROM and quality of reporting over overlapping meta-analysis on the role of acetylcysteine in the prevention of contrast associated nephropathy: case study. Br Med J 332:202–209
Blaufox MD, Aurell M, Bubeck B et al (1996) Report of the radionuclide in nephrourology committee on renal clearance. J Nucl Med 37:1883–1890
Bolen S, Feldman L, Vassy J et al (2007) Systematic review: comparative effectiveness and safety of oral medications for type 2 diabetes mellitus. Ann Intern Med 147:386–399
Bostrom AG, Kronenberg F, Ritz E (2002) Predictive performance of renal function equations for patients with chronic kidney disease and normal serum creatinine levels. J Am Soc Nephrol 13:2140–2144
Botev R, Mallie P, Wetzels J, Couch C (2011) The clinician and estimated glomerular filtration rate. Clin J Am Soc Nephrol 6:937–950
Brar SS, Hiremath S, Dangas G et al (2009) Sodium bicarbonate for the prevention of contrast induced-acute kidney injury: a systematic review and meta-analysis. Clin J Am Soc Nephrol 4:1584–1592
Briguori C, Colombo A, Airoldi F et al (2004a) N-acetylcysteine versus fenoldopam mesylate to prevent contrast agent-associated nephrotoxicity. J Am Coll Cardiol 44:762–765
Briguori C, Colombo A, Violante A et al (2004b) Standard versus double dose of N-acetylcysteine to prevent contrast agent associated nephrotoxicity. Eur Heart J 25:206–211
Briguori C, Colombo A, Airoldi F et al (2006) Nephrotoxicity of low-osmolality versus iso-osmolality contrast agents: impact of N-acetylcysteine. Kidney Int 68:2250–2255
Briguori C, Airoldi F, D’Andrea D et al (2007) Renal insufficiency following contrast media administration trial (REMEDIAL): a randomized comparison of 3 preventive strategies. Circulation 115:1211–1217
Carraro M, Mancini W, Artero M et al (1996) Dose effect of nitrendipine on urinary enzymes and microproteins following nonionic radiocontrast administration. Nephrol Dial Transplant 11:444–448
Carraro M, Malalan F, Antonione R et al (1998) Effects of a dimeric vs a monomeric nonionic contrast medium on renal function in patients with mild to moderate insufficiency: a double blind, randomized trial. Eur Radiol 8:144–147
Cavusoglu E, Chabra S, Marmur JD et al (2004) The prevention of contrast-induced nephropathy in patients undergoing percutaneous coronary intervention. Minerva Cardioangio 52:419–432
Chalmers N, Jackson RW (1999) Comparison of iodixanol and iohexol in renal impairment. Br J Radiol 72:701–703
Chen Y, Hu S, Liu Y et al (2012) Renal tolerability of iopromide and iodixanol in 562 renally impaired patients undergoing cardiac catheterisation: the DIRECT study. EuroIntervention 8:830–838
Chertow GM, Burdich E, Honour M et al (2005) Acute kidney injury, mortality, length of stay, and costs in hospitalized patients. J Am Soc Nephrol 16:3365–3370
Cheruvu B, Henning K, Mulligan J et al (2007) Iodixanol: risk of subsequent contrast nephropathy in cancer patients with underlying renal insufficiency undergoing diagnostic computed tomography examinations. J Comput Assist Tomogr 31:493–498
Choyke PL, Cady K, DePollar SL, Austin H (1998) Determination of serum creatinine prior to iodinated contrast media: is it needed in all patients? Tech Urol 4:65–69
Chuang F-R, Chen T-C, Wang I-K (2009) Comparison of iodixanol and iohexol in patients undergoing intravenous pyelography: a prospective controlled study. Ren Fail 31:181–188
Clavijo LC, Pinto TL, Kuchulakanti PK et al (2006) Effect of a rapid intraarterial infusion of dextrose 5 % prior to coronary angiography on frequency of contrast-induced nephropathy in high-risk patients. Am J Cardiol 97:981–983
Cockroft DW, Gault MH (1976) Prediction of creatinine clearance from serum creatinine. Nephron 16:31–41
Couchoud C, Pozet N, Labeeuw M, Pouteil-Noble C (1999) Screening early renal failure: cut-off values for serum creatinine as an indicator of renal impairment. Kidney Int 55:1878–1884
Cramer BC, Parfrey PS, Hutchinson TA et al (1985) Renal function following infusion of radiologic contrast material: a prospective controlled study. Arch Intern Med 145:87–89
Cryer DR, Nicholas SP, Henry DH et al (2005) Comparative outcomes study of metformin intervention versus conventional approach: the COSMIC approach study. Diabetes Care 28:539–543
Curham GC (2003) Prevention of contrast nephropathy. JAMA 289:606–608
Dai B, Liu Y, Fu L et al (2012) Effect of theophylline on prevention of contrast-induced acute kidney injury: a meta-analysis of randomized controlled trials. Am J Kidney Dis 60:360–370
Davenport MS, Khalatbari S, Dillamn JR et al (2013) Contrast material-induced nephrotoxicity and intravenous low-osmolality iodinated contrast material. Radiology 267:94–105
Davidson CJ, Hlatky M, Morrris KG et al (1989) Cardiovascular and renal toxicity of a nonionic radiographic contrast agent after cardiac catheterization. A prospective trial. Ann Intern Med 110:119–124
Dittrich E, Puttinger H, Schillinger M (2006) Effect of radio contrast media on residual function in peritoneal dialysis patients—a prospective study. Nephrol Dial Transplant 21:1334–1339
Dussol B, Morange S, Loundoun A et al (2006) A randomized trial of saline hydration to prevent contrast nephropathy in chronic renal failure patients. Nephrol Dial Transplant 21:2120–2126
Eken C, Kilicaslan I (2007) Differences between various glomerular filtration rate calculation methods in predicting patients at risk for contrast-induced nephropathy. Am J Emerg Med 25:487 (Correspondence)
Electronic Medicines Compendium (2012a) www.medicines.org.uk/EMC/medicine/1043/SPC Updated 12-10-10. Accessed 17 Dec 12
Electronic Medicines Compendium (2012b) www.medicines.org.uk/EMC/medicine/20952/SPC Updated 23-5-12. Accessed 17 Dec 12
Erdogan A, Davidson CJ (2003) Recent clinical trials of iodixanol. Rev Cardiovasc Med 4(Suppl 5):S43–S50
Erley CM, Duda SH, Rehfuss D et al (1999) Prevention of radiocontrast-media-induced nephropathy in patients with pre-existing renal insufficiency by hydration in combination with the adenosine antagonist theophylline. Nephrol Dial Transplant 14:1146–1149
Fishbane S, Durham JH, Marzo K, Rudnick M (2004) N-acetylcysteine in the prevention of radiocontrast-induced nephropathy. J Am Soc Nephrol 15:251–260
Fishman EK, Reddan D (2008) What are radiologists doing to prevent contrast-induced nephropathy (CIN) compared with measures supported by current evidence? A survey of European radiologists on CIN associated with computed tomography. Acta Radiol 49:310–320
Fliser D, Laville M, Covic A et al (2012) A European Renal Best Practice (ERBP) position statement on the Kidney Disease Improving Global Outcomes (KDIGO) clinical practice guidelines on acute kidney injury: part 1: definitions, conservative management and contrast-induced nephropathy. Nephrol Dial Transplant 27:4263–4273
From AM, Bartholmai BJ, Williams AW et al (2008) Mortality associated with nephropathy after radiographic contrast exposure. Mayo Clin Proc 83:1095–1100
Fu N, Lia X, Yang S et al (2013) Risk score for the prediction of contrast-induced nephropathy in elderly patients undergoing percutaneous coronary intervention. Angiology 64:188–194
Gare M, Haviv YS, Ben-Yehuda A et al (1999) The renal effect of low-dose dopamine in high-risk patients undergoing coronary angiography. J Am Coll Cardiol 34:1682–1688
Gleeson T, Bulugahapitiya S (2004) Contrast induced nephropathy. Am J Roentgenol 183:1673–1689
Goergen SK, Rumbold G, Compton G, Harris C (2010) Systematic review of current guidelines, and their evidence base, on risk of lactic acidosis after administration of contrast medium for patients receiving metformin. Radiology 254:261–269
Goldenberg I, Matezky S (2005) Nephropathy induced by contrast media: pathogenesis, risk factors and preventive strategies. CMAJ 172:1461–1467
Gomes VO, Lasevitch R, Lima VC et al (2012) Hydration with sodium bicarbonate does not prevent contrast nephropathy: a multicenter clinical trial. Arq Bras Cardiol 99:1129–1134
Gruberg L, Mintz GS, Mehran R et al (2000) The prognostic implications of further renal function deterioration with 48 h of interventional coronary procedures in patients with pre-existent chronic renal insufficiency. J Am Coll Cardiol 36:1542–1548
Gupta RK, Kapoor A, Tewari S et al (1999) Captopril for prevention of contrast-induced nephropathy in diabetic patients: a randomised study. Indian Heart J 51:521–536
Hans SS, Hans BA, Dhillon R et al (1998) Effect of dopamine on renal function after arteriography in patients with pre-existing renal insufficiency. Am Surg 64:432–436
Hardiek KJ, Katholi RE, Robbs RS, Katholi CE (2008) Renal effects of contrast media in diabetic patients undergoing diagnostic or interventional coronary angiography. J Diabetes Complications 22:171–177
Haylor JL, Morcos SK (2000) Endothelin antagonism and contrast nephropathy. Kidney Int 58:2239
Heinrich MC, Häberle L, Müller V et al (2009) Nephrotoxicity of iso-osmolar iodixanol compared with nonionic low-osmolar contrast media: meta-analyses of randomized controlled trials. Radiology 250:68–86
Heinrich MC, Kuhlmann MK, Grgic A et al (2005) Cytotoxic effects of ionic high-osmolar, nonionic monomeric, and nonionic iso-osmolar dimeric iodinated contrast media on renal tubular cells in vitro. Radiology 235:843–849
Heller CA, Knapp J, Halliday et al (1991) Failure to demonstrate contrast nephrotoxicity. Med J Aust 155:329–332
Heyman SN, Rosenberger C, Rosen S (2005) Regional alterations in renal haemodynamics and oxygenation: a role contrast medium-induced nephropathy. Nephrol Dial Transplant 20(Suppl 1):i6–i11
Higgins JPT, Thompson SG, Deeks JJ, Altman DG (2003) Measuring inconsistency in meta-analysis. Br Med J 327:557–560
Hoffmann U, Fischereder M, Kruger B et al (2004) The value of N-acetylcysteine in the prevention of radiocontrast agent-induced nephropathy seems questionable. J Am Soc Nephrol 15:407–410
Hogan SE, L'Allier P, Chetcuti S et al (2008) Current role of sodium bicarbonate-based preprocedural hydration for the prevention of contrast-induced acute kidney injury: a meta-analysis. Am Heart J 156:414–421
Holstein A, Stumvoll M (2005) Contraindications can damage your health- is metformin a case in point? Diabetologia 48:2454–2459
Hoste EAJ, Doom S, De Waele J et al (2011) Epidemiology of contrast-associated acute kidney injury in ICU patients: a retrospective cohort analysis. Intensive Care Med 37:1921–1931
Hou SH, Bushinsky DA, Wish JB et al (1983) Hospital acquired renal insufficiency: a prospective study. Am J Med 74:243–248
Huber W, Ilgman K, Page M et al (2002) Effect of theophylline on contrast material-induced nephropathy on patients with chronic renal insufficiency: controlled, randomized, double-blinded study. Radiology 223:772–779
Ix JH, McCullough CE, Chertow GM (2004) Theophylline for the prevention of radiocontrast nephropathy: a meta-analysis. Nephrol Dial Transplant 19:2747–2753
Jabara R, Gadesam RR, Pendyla LK (2009) Impact of the definition utilizes on the rate of contrast-induced nephropathy in percutaneous coronary intervention. Am J Cardiol 103:1657–1662
Jakobsen JA, Lundby B, Kristoffersen DT et al (1992) Evaluation of renal function with delayed CT after injection of non- ionic monomeric and dimeric contrast media in healthy volunteers. Radiology 182:419–424
James MT, Ghali WA, Knudtson ML et al (2011) Alberta Provencial Project for Outcome Assessment in Coronary Heart Disease (APPROACH) Investigators. Associations between acute kidney injury and cardiovascular and renal outcomes after coronary angiography. Circulation 123:409–416
Jingwei N, Ruiyan Z, Jiansheng Z et al (2006) Safety of isoosmolar dimer during percutaneous coronary intervention. J Interv Radiol 15:327–329
Jo S-H, Youn T-J, Koo B-K et al (2006) Renal toxicity evaluation and comparison betweenVisipaque (iodixanol) and Hexabrix (ioxaglate) in patients with renal insufficiency undergoing coronary angiography. The RECOVER study: a randomized controlled trial. J Am Coll Cardiol 48:924–930
Joannidis M, Schmid M, Wiedermann CJ (2008) Prevention of contrast media-induced nephropathy by isotonic sodium bicarbonate: a meta-analysis. Wien Klin Wochenschr 120:742–748
Katzberg RW (1997) Urography into the 21st century: new contrast media, renal handling, imaging characteristics, and nephrotoxicity. Radiology 204:297–312
Katzberg R (2005) Contrast medium-induced nephrotoxicity: which pathways? Radiology 235:752–755
Katzberg R, Barrett B (2007) Risk of contrast-induced nephropathy with intravenous administration of iodinated contrast media. Radiology 243:622–628
Kidney Disease: Improving Global Outcomes (KDIGO) (2013) CKD Work Group. KDIGO 2012 Clinical practice guideline for the evaluation and management of chronic kidney disease. Kidney Int Suppl 3:1–150
Kini AS, Mitre CA, Kim M et al (2002) A protocol for prevention of radiographic contrast nephropathy during percutaneous coronary intervention: effect of selective dopamine receptor agonist fenoldopam. Catheter Cardiovasc Interv 55:169–173
Kim KS, Kim K, Hwang SS et al (2011) Risk stratification nomogram for nephropathy after abdominal contrast-enhanced computed tomography. Am J Emerg Med 29:412–417
Kim IY, Lee SB, Lee DW et al (2012) Long-term effects of radiocontrast-enhanced computed tomography on the renal function of chronic kidney disease patients. Clin Exp Nephrol 16:755–759
Kolehmainen H, Soiva M (2003) Comparison of Xenetix 300 and Visispaque 320 in patients with renal failure. Eur Radiol 13:B32–B33
Krasuski RA, Beard BM, Geoghagan JD et al (2003) Optimal timing of hydration to erase contrast-associated nephropathy: the OTHER CAN study. J Invasive Cardiol 15:699–702
Kshirsagar AV, Poole C, Mottl A et al (2004) N-acetylcysteine for the prevention of radiocontrast induced nephropathy: a metaanalysis of prospective controlled trials. J Am Soc Nephrol 15:761–769
Kuhn MJ, Chen N, Sahani DV et al (2008) The PREDICT study: a randomized double-blind comparison of contrast-induced nephropathy after low- or isoosmolar contrast agent exposure. Am J Roentgenol 1991:151–157
LaBounty TM, Shah M, Raman SV et al (2012) Within-hospital and 30-day outcomes in 107,994 patients undergoing invasive coronary angiography with different low-osmolar iodinated contrast media. Am J Cardiol 109:1594–1599
Lameire NH (1997) The impact of residual renal function on the adequacy of peritoneal dialysis. Nephron 77:13–28
Laskey W, Aspelin P, Davidson C et al (2009) Nephrotoxicity of iodixanol versus iopamidol in patients with chronic kidney disease and diabetes mellitus undergoing coronary angiographic procedures. Am Heart J 158:822–828
Ledermann HP, Mengiardi B, Schmid A, Froehlich JM (2010) Screening for renal insufficiency following ESUR guidelines with on-site creatinine measurements in an outpatient setting. Eur Radiol 20:1926–1933
Levey AS, Bosch JP, Lewis JB et al (1999) A more accurate method to estimate glomerular filtration rate from serum creatinine: a new prediction equation. Ann Intern Med 130:461–470
Levey AS, Stevens LA, Schmid CH et al (2009) A new equation to estimate glomerular filtration rate. Ann Intern Med 150:604–612
Liu R, Nair D, Ix J et al (2005) N-acetylcysteine and contrast- induced nephropathy: systematic review and metaanalysis. J Gen Intern Med 20:193–200
Love L, Johnson MS, Bresler ME et al (1994) The persistent computed tomography nephrogram: its significance in the diagnosis of contrast-associated nephrotoxicity. Br J Radiol 67:951–957
Maeder M, Klein M, Fehr T, Rickli H (2004) Contrast nephropathy: review focusing on prevention. J Am Coll Cardiol 44:1763–1771
Marenzi G, Lauri G, Assanelli E et al (2004) Contrast-induced nephropathy in patients undergoing primary angioplasty for acute myocardial infarction. J Am Coll Cardiol 44:1780–1785
Marenzi G, Assanelli E, Marana I et al (2006) N-acetylcysteine and contrast-induced nephropathy in primay angioplasty. N Engl J Med 354:273–278
Marenzi G, Ferrari C, Marana I et al (2012) Prevention of contrast nephropathy by furosemide with matched hydration. The MYTHOS (induced diuresis with matched hydration compared to standard hydration for contrast induced nephropathy prevention) Trial. JACC Cardiovasc Interv 5:90–97
McCarthy CS, Becker JA (1992) Multiple myeloma and contrast media. Radiology 183:519–521
McCullough PA, Bertrand ME, Brinker JA, Stacul F (2006a) A meta-analysis of the renal safety of iso-osmolar iodixanol compared with low-osmolar contrast media. J Am Coll Cardiol 48:692–699
McCullough PA, Sandberg KR (2003) Epidemiology of contrast induced nephropathy. Rev Cardiovasc Med 4:53–59
McCullough PA, Stacul F, Becker CR et al (2006b) Contrast-Induced Nephropathy (CIN) consensus working panel: executive summary. Rev Cardiovasc Med 7(4):177–197
McCullough PA, Wolyn R, Rocher LL et al (1997) Acute renal failure after coronary intervention: incidence, risk factors and relationship to mortality. Am J Med 103:368–375
McDonald JS, McDonald RJ, Comin J et al (2013a) Frequency of acute kidney injury following intravenous contrast administration: a systemic review and meta-analysis. Radiology 267:119–128
McDonald RJ, McDonald JS, Bida JP et al (2013b) Intravenous contrast material-induced nephropathy: causal or coincident phenomenon? Radiology 267:106–118
Mehran R, Aymong ED, Nikolsky E et al (2004) A simple risk score for prediction of contrast-induced nephropathy after percutaneous coronary intervention. Development and initial validation. J Am Coll Cardiol 44:1393–1399
Mehran R, Nikolsky E, Kirtane AJ et al (2009) Ionic low-osmolar versus nonionic iso-osmolar contrast media to obviate worsening nephropathy after angioplasty in chronic renal failure patients: the ICON (Ionic versus non-ionic Contrast to Obviate worsening Nephropathy after angioplasty in chronic renal failure patients) study. JACC Cardiovasc Interv 2:415–421
Mehta RL, Kellum JA, Shah SV et al (2007) Acute kidney injury network. Acute kidney network; report of an initiative to improved outcomes in acute kidney injury. Crit Care 121:R31
Meier P, Ko DT, Tamura A et al (2009) Sodium bicarbonate-based hydration prevents contrast-induced nephropathy: a meta-analysis. BMC Med 7:23
Merten GJ, Burgess WP, Gray LV et al (2004) Prevention of contrast induced nephropathy with sodium bicarbonate: a randomized trial. JAMA 291:2328–2338
Meschi M, Detrenis S, Musini S et al (2006) Facts and fallacies concerning the prevention of contrast medium induced nephropathy. Crit Care Med 34:2060–2068
Mitchell RL, Craig JC, Webster AC (2004) Cochrane renal group report. Am J Kidney Dis 43:752–756
Michels WM, Grootendorst DC, Verduijn M et al (2010) Performance of the Cockcroft-Gault, MDRD, and new CKD-EPI formulas in relation to GFR, age, and body size. Clin J Am Soc Nephrol 5:1003–1009
Molitoris BA, Levin A, Warnock DG et al (2007) Improving outcomes of acute kidney injury: report of an initiative. Nat Clin Pract Nephrol 3:439–442
Morcos SK (1998) Contrast media-induced nephrotoxicity—questions and answers. Br J Radiol 71:357–365
Morcos SK (2004) Prevention of contrast media nephrotoxicity—the story so far. Clin Radiol 59:381–389
Morcos SK (2005) Prevention of contrast media-induced nephrotoxicity after angiographic procedures. J Vasc Interv Radiol 16:13–23
Morcos SK, Thomsen HS, Webb JAW and members of contrast media safety committee of the European Society of Urogenital Radiology (ESUR) (1999) Contrast media induced nephrotoxicity: a consensus report. Eur Radiol 9:1602–1613
Mueller C, Burkle G, Buerkle HJ et al (2002) Prevention of contrast media-associated nephropathy. Randomized comparison of 2 hydration regimens in 1620 patients undergoing coronary angioplasty. Arch Intern Med 162:329–336
Nash K, Hafeez A, Hou S (2002) Hospital-acquired renal insufficiency. Am J Kidney Dis 39:930–936
Navaneethan SD, Singh S, Appasamy S et al (2009) Sodium bicarbonate therapy for prevention of contrast-induced nephropathy: a systematic review and meta-analysis. Am J Kidney Dis 53:617–627
Naughton CA (2008) Drug-induced nephrotoxicity. Am Fam Physician 78:743–750
Neumayer HH, Junge W, Kufner A, Wenning A (1989) Prevention of radiocontrast-media-induced nephrotoxicity by calcium channel blocker nitrendipine: a prospective randomized clinical trial. Nephrol Dial Transplant 4:1030–1036
Newhouse JH, Do Kho, Rao QA, Starren J (2008) Frequency of serum creatinine changes in the absence of iodinated contrast material: implications for studies of contrast nephrotoxicity. AJR Am J Roentgenol 191:376–382
Nguyen SA, Suranyi P, Ravenel JG et al (2008) Iso-osmolality versus low-osmolality iodinated contrast medium at intravenous contrast-enhanced CT: effect on kidney function. Radiology 248:97–105
NICE Clinical Guideline CG 87 (2009) Type 2 Diabetes—The management of type 2 diabetes. http://publications.nice.org.uk/type-2-diabetes-cg87/guidance. Updated March 2010. Accessed 17 Dec 12
Nicholson T, Downes M (2003) Contrast nephrotoxicity and iso-osmolar contrast agents; implications of NEPHRIC. Clin Radiol 58:659–660
Nikolsky E, Mehran R (2003) Understanding the consequences of contrast-induced nephropathy. Rev Cardovasc Med 4(Suppl 5):S10–S18
Oldroyd SD, Haylor JL, Morcos SK (1995) Bosentan, an orally active endothelin antagonist: effect on the renal response to contrast media. Radiology 196:661–665
Oldroyd SD, Fang L, Haylor JL et al (2000) Effects of adenosine receptor antagonists on the responses to contrast media in the isolated rat kidney. Clin Sci 98:303–311
Olsen JC, Salomon B (1996) Utility of the creatinine prior to intravenous contrast studies in the emergency department. J Emerg Med 14:543–546
O’Sullivan S, Healy DA, Molony MC et al (2013) The role of N-acetylcysteine in the prevention of contrast-induced nephropathy in patients undergoing peripheral angiography: a structured review and meta-analysis. Angiology doi:10.1177/0003319712467223
Pahade JK, LeBedis CA, Raptopoulos VD et al (2011) Incidence of contrast-induced nephropathy in patients with multiple myeloma undergoing contrast-enhanced CT. AJR Am J Roentgenol 196:1094–1101
Pannu N, Manns B, Lee H, Tonelli M (2004) Systematic review of the impact of N-acetylcysteine on contrast nephropathy. Kidney Int 65:1366–1374
Pannu N, Nadim MK (2008) An overview of drug-induced acute kidney injury. Crit Care Med 36(4 Suppl):S216–S223
Pannu N, Wiebe N, Tonelli M for the Alberta Kidney Disease Network (2006) Prophylaxis strategies for contrast-induced nephropathy. JAMA 295:2765–2779
Parfrey PS, Griffiths SM, Barrett BJ et al (1989) Contrast material-induced renal failure in patients with diabetes mellitus, renal insufficiency or both. New Engl J Med 320:143–149
Poletti PA, Saudan P, Platon A et al (2007) I.V. N-acetylcysteine and emergency CT: use of serum creatinine and Cystatin C as markers of radiocontrast nephrotoxicity. Am J Roentgenol 189:687–692
Pugh ND, Sissons GR, Ruttley et al (1993) Iodixanol in femoral arteriography (phase III): a comparative double double-blind parallel trial between iodixanol and iopromide. Clin Radiol 47:96–99
Recio-Mayoral A, Chaparro M, Pardo B et al (2007) The reno- protective effect of hydration with sodium bicarbonate plus N-acetylcysteine in patients undergoing emergency percutaneous coronary intervention: the RENO study. J Am Coll Cardiol 49:1238–1283
Reddan D, Fishman EK (2008) Radiologists’ knowledge and perceptions of the impact of contrast-induced nephropathy and its risk factors when performing computed tomography examinations: a survey of European radiologists. Eur J Radiol 66:235–245
Reddan D, Laville M, Garovic VD (2009) Contrast-induced nephropathy and its prevention: what do we really know from evidence-based findings? J Nephrol 22:333–351
Rudnick MR, Goldfarb S, Wexler L et al (1995) Nephrotoxicity of ionic and nonionic contrast media in 1196 patients: a randomized trial. Kidney Int 47:254–261
Sadeghi HM, Stone GW, Grines CL et al (2003) Impact of renal insufficiency in patients undergoing primary angioplasty for acute myocardial infarction. Circulation 108:2769–2775
Safirstein R, Andrade L, Viera JM (2000) Acetylcysteine and nephrotoxic effects of radiographic contrast agents—a new use for an old drug. N Engl J Med 342:210–211
Salpeter S, Greyber E, Pasterank G, Salpeter EE (2010) Risk of fatal and nonfatal lactic acidosis with metformin use in type 2 diabetes mellitus. Cochrane Database Syst Rev 25(1):CD 002967
Sambol NC, Chiang J, Lin ET et al (1995) Kidney function and age are both predictors of pharmacokinetics of metformin. J Clin Pharmacol 35:1094–1102
Seeliger E, Sendeski M, Rihal CS, Persson PB (2012) Contrast-induced kidney injury: mechanisms, risk factors, and prevention. Eur Heart J 33:2007–2015
Sharma SK, Kini A (2005) Effect of nonionic radiocontrast agents on the occurrence of contrast-induced nephropathy in patients with mild-moderate chronic renal insufficiency: pooled analysis of the randomized trials. Catheter Cardiovasc Interv 65:386–393
Shaw JS, Wilmot RL, Kilpatrick ES (2007) Establishing pragmatic estimated GFR thresholds to guide metfromin prescribing. Diabet Med 24:1160–1163
Sholy H, Zukerman R, Soni A, Nikolsky E (2012) Contrast induced nephropathy; an update on diagnosis, predictors, implications and preventive strategies. Minerva Med 103:465–486
Slocum NK, Grossman PM, Moscucci M (2012) The changing definition of contrast-induced nephropathy and its clinical implications insights from the Blue Cross Blue Shield of Michigan Cardiovascular Consortium (BMC2). Am Heart J 163:829–834
Solomon R (1998) Contrast medium-induced acute renal failure. Kidney Int 53:230–242
Solomon R (2005) The role of osmolality in the incidence of contrast-induced nephropathy: a systematic review of angiographic contrast media in high risk patients. Kidney Int 68:2256–2263
Solomon R, DuMouchel W (2006) Contrast media and nephropathy. Findings from systematic analysis and food and drug administration reports of adverse effects. Invest Radiol 41:651–660
Solomon R, Werner C, Mann D et al (1994) Effects of saline, mannitol and furosemide on acute decreases in renal function induced by radiocontrast agents. N Engl J Med 331:1416–1420
Solomon R, Natarajan M, Doucet S et al (2007) The cardiac- angiography in renally impaired patients (CARE) study: a randomized, double blind trial of contrast-induced nephropathy (CIN) in high risk patients. Circulation 115:3189–3196
Spargias K, Alexopoulos E, Kyrzopoulos S et al (2004) Ascorbic acid prevents contrast mediated nephropathy in patients with renal dysfunction undergoing coronary angiography or intervention. Circulation 110:2837–2842
Stacul F, van der Molen AJ, Reimer P et al (2011) Contrast induced nephropathy: updated ESUR Contrast Media Safety committee guidelines. Eur Radiol 21:2327–2541
Stang M, Wysowski DK, Butler-Jones D (1999) Incidence of lactic acidosis in metformin users. Diabetes Care 22:925–927
Stevens MA, McCullough PA, Tobin KJ et al (1999) A prospective randomized trial of prevention measures in patients at high risk for contrast nephropathy. Results of the P.R.I.N.C.E study. J Am Coll Cardiol 33:403–411
Stevens LA, Coresh J, Greene T, Levey AS (2006) Assessing kidney function—measured and estimated glomerular filtration rate. N Engl J Med 354:2473–2483
Stone GW, McCullough PA, Tumlin JA et al (2003) Contrast investigators. Fenoldopam mesylate for the prevention of contrast-induced nephropathy: a randomized controlled trial. JAMA 290:2284–2291
Stratta P, Izzo C, Canavese C, Quaglia M (2013) Letter to the Editor re: are intravenous injections of contrast media really less nephrotoxic than intra-arterial injections? Eur Radiol 23:1260–1263
Suzuki H, Kanno Y, Sugahara S (2004) Effects of an angiotensin II receptor blocker, valsartan, on residual renal function in patients on CAPD. Am J Kidney Dis 43:1056–1064
Tamura A, Goto Y, Miyamoto K et al (2009) Efficacy of single bolus administration of sodium bicarbonate to prevent contrast induced nephropathy in patients with mild renal insufficiency undergoing an elective coronary procedure. Am J Cardiol 104:921–925
Taylor AJ, Hotchkiss D, Morse RW, McCabe J (1998) PREPARED. Preparation for angiography in renal dysfunction: a randomized trial of inpatient vs outpatient hydration protocols for cardiac catheterization in mild-to-moderate renal dysfunction. Chest 114:1570–1574
Tepel M, Giet MVD, Schwarzfeld C et al (2000) Prevention of radiographic-contrast-agent-induced reductions in renal function by acetylcysteine. N Engl J Med 343:180–184
Thomsen HS (1999) Contrast nephropathy. In: Thomsen HS, Muller RN, Mattrey RF (eds) Trends in contrast media. Springer, Berlin, pp 103–116
Thomsen HS (2004) Gadolinium-based contrast media may be nephrotoxic even at approved doses (case report). Eur Radiol 15:749–754
Thomsen HS, Golman K, Hemmingsen L et al (1993) Contrast medium induced nephropathy: animal experiments. Front Eur Radiol 9:83–108
Thomsen HS, Morcos SK, Members of Contrast Media Safety Committee of European Society of Urogenital Radiology (ESUR) (2005) In which patients should serum-creatinine be measured before contrast medium administration? Eur Radiol 15:749–756
Thomsen HS, Morcos SK (2006) Contrast-medium-induced nephropathy: is there a new consensus? A review of published guidelines. Eur Radiol 16:1835–1840
Thomsen HS, Morcos SK (2009) Risk of contrast medium induced nephropathy in high risk patients undergoing MDCT—A pooled analysis of two randomized trials. Eur Radiol 19:891–897
Thomsen HS, Morcos SK, Almen T et al (2010) Metformin and contrast media (letter). Radiology 256:672–673
Thomsen HS, Morcos SK, Barrett BJ (2008a) Contrast induced nephropathy: the wheel has turned 360 degrees. Acta Radiol 49:646–657
Thomsen HS, Morcos SK, Erley CM et al (2008b) The ACTIVE trial: comparison of the effects on renal function of iomeprol-400 and iodixanol-320 in patients with chronic kidney disease undergoing abdominal computed tomography. Invest Radiol 43:170–178
Thomsen HS, Morcos SK, ESUR Contrast Media Safety Committee (1999) Contrast media and metformin: guidelines to diminish the risk of lactic acidosis in non-insulin-dependent-diabetics after administration of contrast media. Eur Radiol 9:738–740
Thomsen HS, Reimer P (2014) Intravascular contrast media for radiography, CT, MRI and Ultrasound, Chap 2. In: Adam A, Dixon AK, Gillard JH, Schaefer-Prokop C (eds) Grainger and Allison diagnostic radiology, 6th edn. Oxford: Churchill Livingstone (in press)
Tippins RB, Torres WE, Baumgartner BR, Baumgarten DA (2000) Are screening serum creatinine levels necessary prior to outpatient CT examinations? Radiology 216:481–484
Toprak O (2006) Angiotension converting emzymes inhibitors and contrast-induced nephropathy. Ren Fail 28:99–100
Toprak O, Cirit M, Mayata S et al (2003) The effect of pre-procedural captopril on contrast media induced nephropathy who underwent coronary angiography. Anadolu Kardiyol Derg 3:98–103
Trivedi HS, Moore H, Nasr S et al (2003) A randomized prospective trial to assess the role of saline hydration on the development of contrast nephrotoxicity. Nephron Clin Pract 93:c29–c34
Trivedi H, Foley WD (2010) Contrast-induced nephropathy after a second contrast exposure. Ren Fail 32:786–801
Trivedi H, Nadella R, Szabo A (2010) Hydration with sodium bicarbonate for the prevention of contrast-induced nephropathy: a meta-analysis of randomized controlled trials. Clin Nephrol 74:288–296
Vaitkus PT, Brar C (2007) N-acetylcysteine in the prevention of contrast induced nephropathy: publication bias perpetuated by meta-analysis. Am Heart J 153:175–280
Waikar SS, Bonventre JV (2009) Creatinine kinetics and the definition of acute kidney injury. J Am Soc Nephrol 20:672–679
Wang A, Holcslaw T, Bashore TM et al (2000) Exacerbation of radiocontrast nephrotoxicity by endothelin receptor antagonism. Kidney Int 57:1675–1680
Warren RE, Strachan MWJ, Wild S, McKnight JA (2007) Introducing glomerular filtration rate (eGFR) into clinical practice in the UK: implications for the use of metformin. Diabet Med 24:494–497
Weinstein JM, Heyman S, Brezis M (1992) Potential deleterious effect of furosemide in radiocontrast nephropathy. Nephron 62:413–415
Weisberg L, Kurnik PB, Kurnik RC (1994) Risk of radiocontrast nephropathy in patients with and without diabetes mellitus. Kidney Int 45:259–265
Weisbord SD, Palevsky PM (2008) Prevention of contrast induced nephropathy with volume expansion. Clin J Am Soc Nephrol 3:273–280
Wessely R, Koppara T, Kastrati Aal (2008) Iso-osmolar vs low-osmolar contrast medium in patients with impaired renal function undergoing PCI—CONTRAST. Society for cardiovascular Angiography and Interventions Meeting (SCAI), Chicago, 1 April 2008
Yamazaki H, Matsushita M, Inoue T et al (1997a) Renal cortical retention on delayed CT after angiography and contrast associated nephropathy. Br J Radiol 70:897–902
Yamazaki H, Oi H, Matsushita M et al (1997b) Lack of correlation between gallbladder opacification in delayed CT and contrast-associated nephropathy. Eur Radiol 7:1328–1331
Zagler A, Azadpour M, Mercado C, Hennekens CH (2005) N-acetylcysteine and contrast-induced nephropathy: a meta-analysis of 13 randomized trials. Am Heart J 151:140–145
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Thomsen, H.S., Stacul, F., Webb, J.A.W. (2014). Contrast Medium-Induced Nephropathy. In: Thomsen, H., Webb, J. (eds) Contrast Media. Medical Radiology(). Springer, Berlin, Heidelberg. https://doi.org/10.1007/174_2013_902
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