What is the prognosis of 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

CIN is normally a transient process, with renal function reverting to normal within 7-14 days of contrast administration. Less than one-third of patients develop some degree of residual renal impairment.

Dialysis is required in less than 1% of patients, with a slightly higher incidence in patients with underlying renal impairment (3.1%) and in those undergoing primary percutaneous coronary intervention (PCI) for MI (3%). However, in patients with diabetes and severe renal failure, the rate of dialysis can be as high as 12%.

Of the CIN patients who need dialysis, 18% end up requiring it permanently. However, many of these patients have advanced renal insufficiency and concomitant diabetic nephropathy and would have progressed to needing dialysis regardless of the episode of CIN.

A growing body of knowledge indicates that AKI after contrast medium exposure can be a harbinger of CKD or ESRD. In one observational study that included 3986 patients who underwent coronary angiography, 12.1% of patients experienced contrast-induced AKI, and of those, 18.6% suffered persistent renal damage. [24] The population studied appeared representative of the general population undergoing angiography and the rate of AKI was consonant with other studies. The finding that persistent kidney damage can occur after contrast-induced AKI highlights the potential for acceleration of the progression of kidney injury in individuals with preexisting CKD.


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