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Contrast Medium‐Induced Nephrotoxicity: Pathophysiology and Prevention
Author(s) -
Gerlach Anthony T.,
Pickworth Kerry K.
Publication year - 2000
Publication title -
pharmacotherapy: the journal of human pharmacology and drug therapy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.227
H-Index - 109
eISSN - 1875-9114
pISSN - 0277-0008
DOI - 10.1592/phco.20.6.540.35154
Subject(s) - nephrotoxicity , medicine , dialysis , creatinine , contrast medium , adverse effect , intensive care medicine , renal function , urology , toxicity , radiology
Contrast medium‐induced nephrotoxicity (CMN) is a common form of iatrogenic acute renal failure. Typically, patients experience changes in serum creatinine or creatinine clearance between 1 and 5 days after exposure to a contrast medium, but they rarely require dialysis. The mechanism for CMN is not understood, but renal insufficiency, dehydration, and congestive heart failure are risk factors. The frequency of CMN with high‐osmolality versus low‐osmolality media is controversial. Prophylaxis can reduce CMN. Of many different strategies, hydration with normal saline before and after exposure offers the best protection with the fewest adverse effects.