Contrast-Induced Nephropathy

Abstract

Radiocontrast-induced nephropathy (CIN) is the third most common cause of acute renal failure among inpatients. The number of patients undergoing examinations using radiocontrast is increasing, and the population at risk for CIN is growing; this population includes older individuals and those with underlying diabetes mellitus, chronic kidney disease, hypertensive nephropathy, and concomitant use of nephrotoxic drugs. However, little progress in CIN treatment has been made. CIN remains a substantial medical problem because of its association with prolonged hospitalization, the potential need for renal replacement therapy, and increased mortality. The exact pathogenesis of CIN has not been fully elucidated―and multiple factors including tubular renal vasoconstriction, direct renal tubular toxicity, increased oxidative stress, and cellular apoptosis―may contribute to the proximal tubular damage that occurs in patients with CIN. Despite the exploration of numerous prophylactic regimens and treatments, definite therapeutic and preventive strategies for CIN have not been established. This article reviews recent studies involving the risk factors for CIN as well as its pathophysiology and prevention.