Which patients are at greatest risk for acute damage from contrast media (CM)?

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

The risk of acute damage from contrast is greatest in patients with chronic kidney disease (CKD). This can be explained by the increase in single-nephron GFR and, thus, the filtered load of contrast per nephron. This is akin to a double hit to the remaining nephrons: increased contrast load and prolonged tubular exposure. While this may not seem to be a concern in patients with end-stage renal disease (ESRD) who are already on dialysis, residual renal function, in fact, plays a major role in their outcome—more so in patients on peritoneal dialysis. Its preservation is therefore important. [52]


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