AJR 2004; 183:1673-1689.
Gleeson TG, Bulugahapitiya S.
Contrast-induced nephropathy has become a significant source of hospital morbidity and mortality with the ever-increasing use of iodinated contrast media in diagnostic imaging and interventional procedures such as angiography in high-risk patients. It is the third most common cause of hospital-acquired acute renal failure, after surgery and hypotension [1]. In this clinical setting, radiologists must develop an ability to recognize predisposing risk factors, to institute appropriate preproce-dural prophylactic treatments, and to have a knowledge of the clinical presentation and subsequent management of the condition.
Several authors have published in-depth review articles: most notably Katzberg [2], who performed a thorough review of uro-logic contrast agents and their potential effects, and Tublin et al. [1], who published a review in 1998 of current concepts relating to contrast nephropathy. Although many of their concepts still hold true, we intended to concentrate on risk-factor analysis and an updated and comprehensive review of current prophylactic agents, areas that, to date, have not, to our knowledge, been fully addressed while also providing a general overview of the issues relating to contrast-induced nephropathy that may be relevant to the modern radiologist.