Risk Factors for Contrast-Induced Nephropathy (CIN)

Contrast-induced nephropathy (CIN) is defined as the impairment of renal function and is measured as either a 25% increase in serum creatinine (SCr) from baseline or 0.5 mg/dL (44 umol/L) increase in absolute value, within 48-72 hours of intravenous contrast administration.

 

Risk Factors for Contrast-Induced Nephropathy (CIN)

1. Pre-existing renal impairment
2. Diabetes mellitus with renal impairment
3. Reduced intravascular volume

  • Congestive cardiac failure
  • Diuretics (especially furosemide)
  • Abnormal fluid losses
  • Liver failure
  • Nephrotic syndrome
  • Dehydration

4. Prolonged hypotension

  • Concomitant use of diuretic and inhibitors of Angiotensin-Converting Enzyme (ACE)
  • Complication of coronary angiography

5. Contrast media

  • Large volumes (> 140 ml)
  • Repeated injections within 72 hours
  • High osmolarity

6. Diabetes mellitus
7. Nephrotoxic drugs

  • e.g. Non-steroidal anti-inflammatory drugs
  • Aminoglycosides

8. Advanced age
9. Hypertension
10. Proteinuria (including nephrotic syndrome)
11. Multiple myeloma
12. Hypercholesterolaemia
13. Hyperuricaemia
14. Hypercalcaemia
15. Sepsis
16. Atopic allergy

 

 

References:

  1. Gleeson TG, Bulugahapitiya S. Contrast-induced nephropathy. AJR Am J Roentgenol. 2004 Dec;183(6):1673-89. [Medline]
  2. Gleeson TG, O’Dwyer J, Bulugahapitiya S, Foley DP. Contrast-induced nephropathy. Br J Cardiol 2004;11:AIC53-AIC61.

Created: Apr 4, 2009