Which conditions should be included in the differential diagnoses 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

Conditions to consider in the differential diagnosis of contrast-induced nephropathy (CIN) include the following:

  • Atheroembolic renal failure - Occurs more than 1 week after contrast; marked by blue toes, livedo reticularis, transient eosinophilia, prolonged course, and lower recovery than from CIN

  • Acute kidney injury (includes prerenal and postrenal azotemia) - Patients may also have associated dehydration from aggressive diuresis, exacerbated by preexisting fluid depletion; the acute kidney injury is usually oliguric, and recovery is anticipated in 2-3 weeks

  • Acute interstitial nephritis (triad of fever, skin rash, and eosinophilia) - Patients may also have eosinophiluria; the nephritis is usually from drugs such as penicillin, cephalosporins, and nonsteroidal anti-inflammatory drugs (NSAIDs)

  • Acute tubular necrosis - Ischemia from prerenal causes; endogenous toxins, such as hemoglobin, myoglobin, and light chains; exogenous toxins, such as antibiotics, chemotherapeutic agents, organic solvents, and heavy metals


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