Contrast associated and contrast induce acute kidney injury
Keywords:
Acute Kidney Injury (AKI), Contrast-induced Acute Kidney Injury (CI-AKI), Contrast-associated Acute Kidney Injury (CA-AKI), Iodinated Contrast MediaAbstract
Nowadays, iodinated contrast media (ICM) are increasingly used in diagnostic and intervention procedures. This results in the rising incidence of iatrogenic renal function impairment caused by the exposure to ICM. Contrast-induced acute kidney injury (CI-AKI) is a complication associated with the use of ICM. CI-AKI may develop within 48-72 hours after administration of ICM. On the other hand, coincident AKI of any cause that occurs within 48 hours after the administration of contrast media is called contrast-associated acute kidney injury (CA-AKI). Patients with CI-AKI have been found to be strongly associated with morbidity and mortality including development of chronic kidney disease. The pathogenesis of CI-AKI is heterogeneous and incompletely understood. This review investigated the current evidence on CI-AKI definition, pathogenesis, risk factors, and clinical management of CI-AKI. The cornerstones for preventing CI-AKI include the minimization of contrast administration and intravenous fluid hydration. Other adjunctive pharmacotherapies are no consensus recommendations on prophylactic therapies.
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References
1. Mehran R and Nikolsky E. Contrast induced nephropathy: definition. Epidemiology, and patients at risk. Kidney Int 2006; 69: S11-15.
2. Wichmann JL, Katzberg RW, Litwin SE, et al. Contrast induce nephropathy. Circulation 2015; 132: 1931-1936.
3. Uptodate [Internet]. 2021 [cited 2021 Jan 4]. Available from: http://www.uptodate.com/contents/contrast-associated-and-contrast-induced-acute-kidney-injury-clinical-featutes-diagnosis-and-management.
4. Davenport MS, Perazella MA, Yee J, et al. Use of intravenous iodinated contrast media in patients with kidney disease. Radiology 2020; 294: 660-668.
5. American College of Radiology. Manual on contrast media. Version 10.3. Reston, VA: American College of Radiology,2018 [cited 2021 Jan 4]. Available from: http://www.acr.org/Clinical-Resources/Contrast-Manual.
6. Lakhal K, Ehrmann S, Chaari A, et al. Acute Kidney Injury Network definition of contrast-induced nephropathy in the critically ill: incidence and outcome. J Crit Care. 2011; 26: 593-599.
7. Detrenis S, Meschi M, Musini S, et al. Lights and shadows on the pathogenesis of contrast-induced nephropathy: state of art. Nephrol Dial Transplant 2005; 20:1542-1550.
8. Persson PB, Hansell P, Liss P. Pathophysiology of contrast medium-induced nephropathy. Kidney Int 2005; 68(11): 14-22.
9. Marcos R, Kucharik M, Bansal P, et al. Contrast-induced acute kidney injury: review and practical update. Clin Med Insights Cardiol 2019; 13: 1-13.
10. Rosso D, Minutolo R, Cianciaruso B, et al. Early effects of contrast media on renal hemodynamics and tubular function in chronic renal failure. J Am Soc Nephrol 1995; 6(5): 1451-1458.
11. Rudnick MR, Goldfarb S. Pathogenesis of contrast-induced nephropathy: experimental and clinical observations with an emphasis on the role of osmolality. Rev Cardiovasc Med 2003; 4 Suppl 5: S28-33.
12. McDonald RJ, McDonald JS, Bida JP, et al. Intravenous contrast material-induced nephropathy: causal or coincident phenomenon. Radiology 2013; 267(1): 106-118.
13. Davenport MS, Khalatbari S, Cohan RH, et al. Contrast material-induced nephrotoxicity and intravenous low-osmolality iodinated contrast material: risk stratification by using estimated glomerular filtration rate. Radiology 2013; 268(3): 719-728.
14. Ellis JH, Khalatbari S, Yosef M, et a. Influence of clinical factors on risk of contrast-induced nephrotoxicity from iv iodinated low-osmolality contrast material in patients with a low estimated glomerular filtration rate. AJR Am J Roentgenol 2019; 213(5): W188-W193.
15.Dekker IA, van der Molen AJ. Propensity score matching as substitute for randomized controlled trials on acute kidney injury after contrast media administration: A systematic review. AJR AM J Roentagenol 2018; 211: 822-826.
16. Rudnick MR, Leonberg-Yoo AK, Litt HI, et al. The controversy of contrast-induced nephropathy with intravenous contrast: what is the risk. Am J Kidney Dis. 2020; 75(1): 105-113.
17. Hall KA, Wong RW, Hunter GC, et al. Contrast-induced nephrotoxicity: the effects of vasodilator therapy. J Surg Res 1992; 53: 317-320.
18. Schwab SJ, Hlatky M, Morris KG, et al. Contrast nephrotoxicity: a randomized controlled trial of a nonionic and ionic radiographic contrast agent. N Engl J Med 1989; 320-149.
19. Nikolsky E, Mehran R, Turcot D, et al. Impact of chronic kidney disease on prognosis of patients with diabetes mellitus treated with percutaneous coronary intervention. Am J Cardiol 2004; 94: 300-305.
20. Nijssen EC, Rennenberg RJ, Nelemans PJ, et al. Prophylactic hydration to protect renal function from intravascular iodinated contrast material in patients at high risk of contrast induced nephropathy (AMACING): a prospective, randomized, phase 3, controlled, open-label, non-inferiority trial. Lancet 2017; 389(10076): 1312-1322.
21. Kooiman J, Sijpkens YW, van Buren M, et al. Randomised trial of no hydration vs. sodium bicarbonate hydration in patients with chronic kidney disease undergoing acute computed tomography-pulmonary angiography. J Thromb Haemost 2014; 12(10): 1658-1666.
22. Weisbord SD, Gallagher M, Jneid H, et al. Outcomes after angiography with sodium bicarbonate and acetylcysteine. N Engl J Med 2018; 378(7): 603-614.
23. Merten GJ, Burgess WP, Gray LV, et al. Prevention of contrast-induced nephropathy with sodium bicarbonate: a randomized controlled trial. JAMA 2004; 291(19): 2328-2334.
24. Briguori C, Visconti G, Ricciardelli B, et al. Renal insufficiency following contrast media administration trial II (REMEDIAL II): RenalGuard system in high-risk patients for contrast-induced acute kidney injury: rationale and design. EuroIntervention 2011; 6(9): 1117-1122.
25. KDIGO Clinical Practice Guideline for Acute Kidney Injury. Kidney Int Suppl 2012; 2: 8.
26. Zoungas S, Ninomiya T, Huxley R, et al. Systematic review: sodium bicarbonate treatment regimens for the prevention of contrast-induced nephropathy. Ann Intern Med 2009; 151: 631-638.
27. Eng J, Wilson RF, SubramaniamRM, et al. Comparative effect of contrast media type on the incidence of contrast-induced nephropathy: A systematic review and meta-analysis. Ann Intern Med 2016; 164(6): 417-424.
28. Cruz DN, Goh CY, Marenzi G, et al. Renal replacement therapy for prevention of radiocontrast-induced nephropathy: A systematic review. AM J Med 2012; 125(1): 66-78.
29. Rich MW, Crecelius CA. Incidence, risk factors, and clinical course of acute renal insufficiency after cardiac catheterization in patients 70 years of age or older. A prospective study. Arch Intern Med 1990; 150(6): 1237-1242.
30. Rihal CS, Textor SC, Grill DE, et al. Incidence and prognostic importance of acute renal failure after percutaneous coronary intervention. Circulation 2002; 105: 2259-2264.
31. Giacoppo D, Madhavan MV, Baber U, et al. Impact of contrast-induced acute kidney injury after percutaneous coronary intervention on short- and long-term outcomes: Pooled analysis from the HORIZONS-AMI and ACUITY trials. Circ Cardiovasc Interv 2015; 8: e002475
32. From AM, Bartholmai BJ, Williams AW, et al. Mortality associated with nephropathy after radiographic contrast exposure. Mayo Clin Proc 2008; 83(10): 1095-1100.
33. Weisbord SD, Chen H, Stone RA, et al. Associations increase in serum creatinine with mortality and length of hospital stay after coronary angiography. J Am Soc Nephrol 2006; 17(10): 2871-2877.
2. Wichmann JL, Katzberg RW, Litwin SE, et al. Contrast induce nephropathy. Circulation 2015; 132: 1931-1936.
3. Uptodate [Internet]. 2021 [cited 2021 Jan 4]. Available from: http://www.uptodate.com/contents/contrast-associated-and-contrast-induced-acute-kidney-injury-clinical-featutes-diagnosis-and-management.
4. Davenport MS, Perazella MA, Yee J, et al. Use of intravenous iodinated contrast media in patients with kidney disease. Radiology 2020; 294: 660-668.
5. American College of Radiology. Manual on contrast media. Version 10.3. Reston, VA: American College of Radiology,2018 [cited 2021 Jan 4]. Available from: http://www.acr.org/Clinical-Resources/Contrast-Manual.
6. Lakhal K, Ehrmann S, Chaari A, et al. Acute Kidney Injury Network definition of contrast-induced nephropathy in the critically ill: incidence and outcome. J Crit Care. 2011; 26: 593-599.
7. Detrenis S, Meschi M, Musini S, et al. Lights and shadows on the pathogenesis of contrast-induced nephropathy: state of art. Nephrol Dial Transplant 2005; 20:1542-1550.
8. Persson PB, Hansell P, Liss P. Pathophysiology of contrast medium-induced nephropathy. Kidney Int 2005; 68(11): 14-22.
9. Marcos R, Kucharik M, Bansal P, et al. Contrast-induced acute kidney injury: review and practical update. Clin Med Insights Cardiol 2019; 13: 1-13.
10. Rosso D, Minutolo R, Cianciaruso B, et al. Early effects of contrast media on renal hemodynamics and tubular function in chronic renal failure. J Am Soc Nephrol 1995; 6(5): 1451-1458.
11. Rudnick MR, Goldfarb S. Pathogenesis of contrast-induced nephropathy: experimental and clinical observations with an emphasis on the role of osmolality. Rev Cardiovasc Med 2003; 4 Suppl 5: S28-33.
12. McDonald RJ, McDonald JS, Bida JP, et al. Intravenous contrast material-induced nephropathy: causal or coincident phenomenon. Radiology 2013; 267(1): 106-118.
13. Davenport MS, Khalatbari S, Cohan RH, et al. Contrast material-induced nephrotoxicity and intravenous low-osmolality iodinated contrast material: risk stratification by using estimated glomerular filtration rate. Radiology 2013; 268(3): 719-728.
14. Ellis JH, Khalatbari S, Yosef M, et a. Influence of clinical factors on risk of contrast-induced nephrotoxicity from iv iodinated low-osmolality contrast material in patients with a low estimated glomerular filtration rate. AJR Am J Roentgenol 2019; 213(5): W188-W193.
15.Dekker IA, van der Molen AJ. Propensity score matching as substitute for randomized controlled trials on acute kidney injury after contrast media administration: A systematic review. AJR AM J Roentagenol 2018; 211: 822-826.
16. Rudnick MR, Leonberg-Yoo AK, Litt HI, et al. The controversy of contrast-induced nephropathy with intravenous contrast: what is the risk. Am J Kidney Dis. 2020; 75(1): 105-113.
17. Hall KA, Wong RW, Hunter GC, et al. Contrast-induced nephrotoxicity: the effects of vasodilator therapy. J Surg Res 1992; 53: 317-320.
18. Schwab SJ, Hlatky M, Morris KG, et al. Contrast nephrotoxicity: a randomized controlled trial of a nonionic and ionic radiographic contrast agent. N Engl J Med 1989; 320-149.
19. Nikolsky E, Mehran R, Turcot D, et al. Impact of chronic kidney disease on prognosis of patients with diabetes mellitus treated with percutaneous coronary intervention. Am J Cardiol 2004; 94: 300-305.
20. Nijssen EC, Rennenberg RJ, Nelemans PJ, et al. Prophylactic hydration to protect renal function from intravascular iodinated contrast material in patients at high risk of contrast induced nephropathy (AMACING): a prospective, randomized, phase 3, controlled, open-label, non-inferiority trial. Lancet 2017; 389(10076): 1312-1322.
21. Kooiman J, Sijpkens YW, van Buren M, et al. Randomised trial of no hydration vs. sodium bicarbonate hydration in patients with chronic kidney disease undergoing acute computed tomography-pulmonary angiography. J Thromb Haemost 2014; 12(10): 1658-1666.
22. Weisbord SD, Gallagher M, Jneid H, et al. Outcomes after angiography with sodium bicarbonate and acetylcysteine. N Engl J Med 2018; 378(7): 603-614.
23. Merten GJ, Burgess WP, Gray LV, et al. Prevention of contrast-induced nephropathy with sodium bicarbonate: a randomized controlled trial. JAMA 2004; 291(19): 2328-2334.
24. Briguori C, Visconti G, Ricciardelli B, et al. Renal insufficiency following contrast media administration trial II (REMEDIAL II): RenalGuard system in high-risk patients for contrast-induced acute kidney injury: rationale and design. EuroIntervention 2011; 6(9): 1117-1122.
25. KDIGO Clinical Practice Guideline for Acute Kidney Injury. Kidney Int Suppl 2012; 2: 8.
26. Zoungas S, Ninomiya T, Huxley R, et al. Systematic review: sodium bicarbonate treatment regimens for the prevention of contrast-induced nephropathy. Ann Intern Med 2009; 151: 631-638.
27. Eng J, Wilson RF, SubramaniamRM, et al. Comparative effect of contrast media type on the incidence of contrast-induced nephropathy: A systematic review and meta-analysis. Ann Intern Med 2016; 164(6): 417-424.
28. Cruz DN, Goh CY, Marenzi G, et al. Renal replacement therapy for prevention of radiocontrast-induced nephropathy: A systematic review. AM J Med 2012; 125(1): 66-78.
29. Rich MW, Crecelius CA. Incidence, risk factors, and clinical course of acute renal insufficiency after cardiac catheterization in patients 70 years of age or older. A prospective study. Arch Intern Med 1990; 150(6): 1237-1242.
30. Rihal CS, Textor SC, Grill DE, et al. Incidence and prognostic importance of acute renal failure after percutaneous coronary intervention. Circulation 2002; 105: 2259-2264.
31. Giacoppo D, Madhavan MV, Baber U, et al. Impact of contrast-induced acute kidney injury after percutaneous coronary intervention on short- and long-term outcomes: Pooled analysis from the HORIZONS-AMI and ACUITY trials. Circ Cardiovasc Interv 2015; 8: e002475
32. From AM, Bartholmai BJ, Williams AW, et al. Mortality associated with nephropathy after radiographic contrast exposure. Mayo Clin Proc 2008; 83(10): 1095-1100.
33. Weisbord SD, Chen H, Stone RA, et al. Associations increase in serum creatinine with mortality and length of hospital stay after coronary angiography. J Am Soc Nephrol 2006; 17(10): 2871-2877.
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Published
31-08-2021
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วาสุเทพรังสรรค์ ป. Contrast associated and contrast induce acute kidney injury. Singburi Hosp J [internet]. 2021 Aug. 31 [cited 2026 Oct. 18];30(1):1-14. available from: https://he01.tci-thaijo.org/index.php/shj/article/view/248694
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