radiocontrast-induced nephropathy


radiocontrast-induced nephropathy

Nephropathy caused by the use of radiological contrast media, e.g., the dye used during angiography. It is usually defined as one of the following: an increase in the serum creatinine of 0.5 mg/dL within 48 hr of exposure to contrast agents when no other cause is apparent; a decrease in renal function of 25%; or any deterioration in renal function that results in clinically significant adverse effects on a patient’s health.

Patient care

Kidney damage due to injected contrast occurs most often in people who are dehydrated or have diabetes mellitus, heart failure, impaired renal blood flow or kidney disease, liver failure, or multiple myeloma. It sometimes results in serious illness and death, increased hospital length of stay, and end-stage renal disease. Health care professionals should acquire complete medical histories and baseline blood tests to identify at-risk patients. Aggressive preprocedure hydration with sodium bicarbonate in saline decreases the incidence of radiocontrast nephropathy (RCN) in at-risk patients. Maintaining a urine volume more than 150 mL/hr before, during, and after contrast-requiring procedures reduces the rate of RCN significantly.

See also: nephropathy