Does IV contrast provided to hospitalized patients really cause contrast-induced nephropathy (CIN) and lead to acute kidney injury (AKI)? This is quite the controversial discussion at the moment (this was published on 02/24/23). Therefore, I have created this page to compile evidence on the topic. None of this is medical advice. Solely a review on the data published regarding CIN and AKI.
Table of Contents for Contrast-Induced Nephropathy (CIN)
- Is CIN a Myth? Yes? No? Or are we not sure?
- Patients with AKI: Does CIN take place?
- My Interpretation of CIN
Is Contrast-Induced (CIN) Nephropathy a Myth?
Yes
Ehrmann S, Aronson D, Hinson JS. Contrast-associated acute kidney injury is a myth: Yes. Intensive Care Med. 2018 Jan;44(1):104-106. doi: 10.1007/s00134-017-4950-6. Epub 2017 Dec 14. PMID: 29242967.
Link to Article
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No
Weisbord SD, du Cheryon D. Contrast-associated acute kidney injury is a myth: No. Intensive Care Med. 2018 Jan;44(1):107-109. doi: 10.1007/s00134-017-5015-6. Epub 2017 Dec 14. PMID: 29242968.
Link to Article
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We Are Not Sure
Kashani K, Levin A, Schetz M. Contrast-associated acute kidney injury is a myth: We are not sure. Intensive Care Med. 2018 Jan;44(1):110-114. doi: 10.1007/s00134-017-4970-2. Epub 2017 Dec 14. PMID: 29242970.
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In patients with AKI, does giving IV contrast cause additional CIN?
Ehmann MR, Mitchell J, Levin S, Smith A, Menez S, Hinson JS, Klein EY. Renal outcomes following intravenous contrast administration in patients with acute kidney injury: a multi-site retrospective propensity-adjusted analysis. Intensive Care Med. 2023 Feb;49(2):205-215. doi: 10.1007/s00134-022-06966-w. Epub 2023 Jan 30. PMID: 36715705.
Link to Article (NOT FREE)
My interpretation of CIN
I cannot say I personally know the answer but I will quote the paper by Kashani et al. “In clinical practice, decisions regarding contrast administration should weigh individual risk factors with the diagnostic yield and therapeutic consequences of the imaging procedure”. Now that’s a cop-out. I quoted someone else for my interpretation. But they said it better than I could have so there’s that.
Check out additional posts I’ve shared online on eddyjoemd.com/foamed.
Citations
Ehrmann S, Aronson D, Hinson JS. Contrast-associated acute kidney injury is a myth: Yes. Intensive Care Med. 2018 Jan;44(1):104-106. doi: 10.1007/s00134-017-4950-6. Epub 2017 Dec 14. PMID: 29242967.
Link to Article
Link to FULL FREE PDF
Weisbord SD, du Cheryon D. Contrast-associated acute kidney injury is a myth: No. Intensive Care Med. 2018 Jan;44(1):107-109. doi: 10.1007/s00134-017-5015-6. Epub 2017 Dec 14. PMID: 29242968.
Link to Article
Link to FULL FREE PDF
Kashani K, Levin A, Schetz M. Contrast-associated acute kidney injury is a myth: We are not sure. Intensive Care Med. 2018 Jan;44(1):110-114. doi: 10.1007/s00134-017-4970-2. Epub 2017 Dec 14. PMID: 29242970.
Link to Article
Link to FULL FREE PDF
Ehmann MR, Mitchell J, Levin S, Smith A, Menez S, Hinson JS, Klein EY. Renal outcomes following intravenous contrast administration in patients with acute kidney injury: a multi-site retrospective propensity-adjusted analysis. Intensive Care Med. 2023 Feb;49(2):205-215. doi: 10.1007/s00134-022-06966-w. Epub 2023 Jan 30. PMID: 36715705.
Link to Article (NOT FREE)
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