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:
- Gleeson TG, Bulugahapitiya S. Contrast-induced nephropathy. AJR Am J Roentgenol. 2004 Dec;183(6):1673-89. [Medline]
- Gleeson TG, O’Dwyer J, Bulugahapitiya S, Foley DP. Contrast-induced nephropathy. Br J Cardiol 2004;11:AIC53-AIC61.
Created: Apr 4, 2009
