Chia-Ter Chao
Contrast-Induced Nephropathy (CIN) is defined as acute deterioration of renal function after the administration of radio-contrast materials, mostly within a period of 24 to 48 hours. As we perform more contrast-containing procedures and imaging such as coronary angiography and angioplasty or computed tomography, it is expected that CIN will be increasingly common in our day-to-day practice. CIN is projected to account for 15% of episodes of acute kidney injury occurring in hospital. However, CIN carries a long-lasting adverse impact on patient outcomes rather than transient impairment of volume/electrolytes regulation only. The pathophysiological sequences behind include the tubulotoxicity of contrast per se, the induction of oxidative stress in the renal microenvironment, and the vasoactive properties of contrast materials. Although traditionally serum creatinine is utilized as means of diagnosing CIN, the emergence of new biomarkers and new classification schemes of AKI facilitate earlier diagnosis and planning of strategies to mitigate the influence of CIN. It is of paramount importance for physicians to be aware of the clinical features, courses and means of preventing CIN, so as to reduce the incidence of this potentially avoidable complication.
