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KEY FACTS
Terminology
Imaging
Top Differential Diagnoses
Pathology
Clinical Issues
TERMINOLOGY
Abbreviations
- Contrast-induced nephropathy (CIN)
- Acute tubular necrosis (ATN)
- Glomerular filtration rate (GFR)
- Acute kidney injury (AKI)
Synonyms
- Other terms suggested, which remove implied causality of contrast in AKI
- Postcontrast AKI (PC-AKI)
- Contrast-associated AKI (CA-AKI)
- Other terms suggested, which remove implied causality of contrast in AKI
Definitions
- CIN: Sudden deterioration in renal function caused by intravascular administration of iodinated contrast medium
- Causative diagnosis
- Subset of PC-AKI patients
- Differentiation of CIN from PC-AKI incidence requires appropriate control group in studies (rarely performed in available literature)
- AKI: One of following occurs within < 48 hours after nephrotoxic event (Acute Kidney Injury Network criteria)
- Absolute serum creatine increase ≥ 0.3 mg/dL
- Increase in serum creatinine ≥ 50%
- Urine output ≤ 0.6 mL/kg/hour for at least 6 hours
- PC-AKI: Sudden deterioration of renal function occurring < 48 hours following IV administration of iodinated contrast medium
- Correlative diagnosis
- CIN: Sudden deterioration in renal function caused by intravascular administration of iodinated contrast medium
IMAGING
General Features
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Consider
Reporting Tips
Selected References
- American College of Radiology: ACR Manual on Contrast Media. Committee on Drugs and Contrast Media.10.3, 2020
- Davenport MS et al: Use of intravenous iodinated contrast media in patients with kidney disease: consensus statements from the American College of Radiology and the National Kidney Foundation. Kidney Med. 2(1):85-93, 2020
- Kiss N et al: Histopathological evaluation of contrast-induced acute kidney injury rodent models. Biomed Res Int. 2016:3763250, 2016
- Valdenebro M et al: IgA nephropathy associated with acute interstitial nephritis after administering iodinated contrast media. Nefrologia. 35(6):582-4, 2015
- Davenport MS et al: Contrast material-induced nephrotoxicity and intravenous low-osmolality iodinated contrast material: risk stratification by using estimated glomerular filtration rate. Radiology. 268(3):719-28, 2013
- McDonald JS et al: Frequency of acute kidney injury following intravenous contrast medium administration: a systematic review and meta-analysis. Radiology. 267(1):119-28, 2013
- Zoungas S et al: Systematic review: sodium bicarbonate treatment regimens for the prevention of contrast-induced nephropathy. Ann Intern Med. 151(9):631-8, 2009
- Mehta RL et al: Acute Kidney Injury Network: report of an initiative to improve outcomes in acute kidney injury. Crit Care. 11(2):R31, 2007
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Tables
KEY FACTS
Terminology
Imaging
Top Differential Diagnoses
Pathology
Clinical Issues
TERMINOLOGY
Abbreviations
- Contrast-induced nephropathy (CIN)
- Acute tubular necrosis (ATN)
- Glomerular filtration rate (GFR)
- Acute kidney injury (AKI)
Synonyms
- Other terms suggested, which remove implied causality of contrast in AKI
- Postcontrast AKI (PC-AKI)
- Contrast-associated AKI (CA-AKI)
- Other terms suggested, which remove implied causality of contrast in AKI
Definitions
- CIN: Sudden deterioration in renal function caused by intravascular administration of iodinated contrast medium
- Causative diagnosis
- Subset of PC-AKI patients
- Differentiation of CIN from PC-AKI incidence requires appropriate control group in studies (rarely performed in available literature)
- AKI: One of following occurs within < 48 hours after nephrotoxic event (Acute Kidney Injury Network criteria)
- Absolute serum creatine increase ≥ 0.3 mg/dL
- Increase in serum creatinine ≥ 50%
- Urine output ≤ 0.6 mL/kg/hour for at least 6 hours
- PC-AKI: Sudden deterioration of renal function occurring < 48 hours following IV administration of iodinated contrast medium
- Correlative diagnosis
- CIN: Sudden deterioration in renal function caused by intravascular administration of iodinated contrast medium
IMAGING
General Features
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Consider
Reporting Tips
Selected References
- American College of Radiology: ACR Manual on Contrast Media. Committee on Drugs and Contrast Media.10.3, 2020
- Davenport MS et al: Use of intravenous iodinated contrast media in patients with kidney disease: consensus statements from the American College of Radiology and the National Kidney Foundation. Kidney Med. 2(1):85-93, 2020
- Kiss N et al: Histopathological evaluation of contrast-induced acute kidney injury rodent models. Biomed Res Int. 2016:3763250, 2016
- Valdenebro M et al: IgA nephropathy associated with acute interstitial nephritis after administering iodinated contrast media. Nefrologia. 35(6):582-4, 2015
- Davenport MS et al: Contrast material-induced nephrotoxicity and intravenous low-osmolality iodinated contrast material: risk stratification by using estimated glomerular filtration rate. Radiology. 268(3):719-28, 2013
- McDonald JS et al: Frequency of acute kidney injury following intravenous contrast medium administration: a systematic review and meta-analysis. Radiology. 267(1):119-28, 2013
- Zoungas S et al: Systematic review: sodium bicarbonate treatment regimens for the prevention of contrast-induced nephropathy. Ann Intern Med. 151(9):631-8, 2009
- Mehta RL et al: Acute Kidney Injury Network: report of an initiative to improve outcomes in acute kidney injury. Crit Care. 11(2):R31, 2007
