Side Effects of Radiographic Contrast Media : Pathogenesis, Risk Factors, and Prevention

Radiocontrast media (RCM) are medical drugs used to improve the visibility of internal organs and structures in X-ray based imaging techniques. They may have side effects ranging from itching to a life-threatening emergency, known as contrast-induced nephropathy (CIN). We define CIN as acute renal f...

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Bibliographic Details
Published in:BioMed research international 2014-01, Vol.2014 (2014), p.1-20
Main Authors: Andreucci, Michele, Solomon, Richard, Tasanarong, Adis
Format: Article
Language:English
Subjects:
Animals
Biomedical research
Cardiac arrhythmia
Contrast agents
Contrast media
Contrast Media - adverse effects
Drug dosages
Health aspects
Hemodialysis
Humans
Kidney diseases
Kidney Diseases - chemically induced
Kidney Diseases - prevention & control
Medical imaging
Patients
Radiography - adverse effects
Review
Risk Factors
Skin
Thyroid Gland - physiopathology
Tomography
Vomiting
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Summary:Radiocontrast media (RCM) are medical drugs used to improve the visibility of internal organs and structures in X-ray based imaging techniques. They may have side effects ranging from itching to a life-threatening emergency, known as contrast-induced nephropathy (CIN). We define CIN as acute renal failure occurring within 24–72 hrs of exposure to RCM that cannot be attributed to other causes. It usually occurs in patients with preexisting renal impairment and diabetes. The mechanisms underlying CIN include reduction in medullary blood flow leading to hypoxia and direct tubule cell damage and the formation of reactive oxygen species. Identification of patients at high risk for CIN is important. We have reviewed the risk factors and procedures for prevention, providing a long list of references enabling readers a deep evaluation of them both. The first rule to follow in patients at risk of CIN undergoing radiographic procedure is monitoring renal function by measuring serum creatinine and calculating the eGFR before and once daily for 5 days after the procedure. It is advised to discontinue potentially nephrotoxic medications, to choose radiocontrast media at lowest dosage, and to encourage oral or intravenous hydration. In high-risk patients N-acetylcysteine may also be given.
ISSN:2314-6133
2314-6141
DOI:10.1155/2014/741018