Contrast Nephropathy Associated with Percutaneous Coronary Angiography and Intervention
Novak JE, and Handa R. Contrast Nephropathy Associated with Percutaneous Coronary Angiography and Intervention. Cardiology Clinics 2019; 37(3):287-296.
Contrast nephropathy (CN) is acute kidney injury (AKI) that occurs within 24 to 72 hours of iodinated contrast medium (ICM) administration. Mechanisms of CN include hyperviscosity, free radical formation, and renal medullary oxygen supply/demand mismatch. Although risk factors for CN have been identified, it remains uncertain whether ICM causes or is simply associated with AKI. The cornerstones of CN prevention are using low-osmolal ICM, intravenous hydration, and statins, especially in patients with chronic kidney disease. With appropriate CN risk mitigation, coronary angiography and intervention should not be routinely withheld from patients with acute coronary syndromes.