Contrast-Induced Acute Kidney Injury: Evidence in Support of Its Existence and a Review of Its Pathogenesis and Management

The role of contrast-induced nephropathy (CIN) remains controversial. Many experts contend that CIN does not exist or is extremely rare. The diagnosis was previously made too frequently and inappropriately in the presence of coexisting and confounding comorbidities and risk factors making it difficu...

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Bibliographic Details
Published in:International journal of nephrology and renovascular disease 2022-10, Vol.15, p.253-266
Main Authors: Chaudhari, Harshad, Mahendrakar, Smita, Baskin, Stuart E, Reddi, Alluru S
Format: Article
Language:English
Subjects:
Comorbidity
Contrast agents
Contrast media
contrast-associated acute kidney injury
contrast-induced acute kidney injury
Creatinine
Diabetes
Diagnosis
Drug dosages
Hydrocarbons
Intravenous administration
Iodine
Kidney diseases
Kidneys
Medical imaging
Multiple myeloma
Nephropathy
pathophysiology
Patients
prevention
propensity score matching
Review
Risk factors
Terminology
Type 2 diabetes
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Summary:The role of contrast-induced nephropathy (CIN) remains controversial. Many experts contend that CIN does not exist or is extremely rare. The diagnosis was previously made too frequently and inappropriately in the presence of coexisting and confounding comorbidities and risk factors making it difficult to singularly isolate the etiologic role of intravenous contrast media in acute kidney injury (AKI). It is probable that many patients were denied important diagnostic information from radiocontrast studies for fear of CIN. Recently, a new terminology for CIN was introduced, and the term CIN was replaced by two interrelated new terms: one is contrast-associated acute kidney injury (CA-AKI), and the second one is contrast-induced acute kidney injury (CI-AKI). CA-AKI occurs in association with risk factors or comorbidities, therefore, it is a correlative diagnosis. On the other hand, CI-AKI is a subtype of CA-AKI that results directly from iodinated contrast media. In this review, we present evidence from various studies that argue against CI-AKI and also those that suggest its existence but with much lower frequency. We will also provide the current status of the pathophysiology and management of CA-AKI/CI-AKI. Keywords: contrast agents, contrast-induced acute kidney injury, contrast-associated acute kidney injury, pathophysiology, prevention, propensity score matching
ISSN:1178-7058
1178-7058
DOI:10.2147/IJNRD.S371700