What are the risk factors for contrast-induced nephropathy (CIN)?

Updated: Dec 18, 2018
  • Author: Anita Basu, MD, FACP; Chief Editor: Vecihi Batuman, MD, FASN  more...
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Answer

Many physicians who refer patients for contrast procedures and some who perform the procedure themselves are not fully informed about the risk of CIN. A survey found that fewer than half of referring physicians were aware of potential risk factors, including ischemic heart disease and diabetes mellitus. [5] (See DDx.)

A lack of consensus exists regarding the definition and treatment of CIN. Studies differ in regard to the marker used for renal function (SCr versus estimated glomerular filtration rate [eGFR]), the day of initial measurement and remeasurement of the marker, and the percentage increase used to define CIN. This makes it difficult to compare studies, especially in terms of the efficacy of various treatment modalities. [6] (See Treatment and Medication.)

The reported incidence of CIN might be an underestimation. SCr levels normally rise by day 3 after contrast administration. Most patients do not remain hospitalized for long and there is no specific protocol to order outpatient SCr levels 3-5 days after the procedure.

CT scans with contrast are sometimes withheld for fear of CIN. However, a recent study suggests that this risk may be minimal (see Overview/Epidemiology). [7]


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