Chrysovalantis Vergadis*, Georgios Festas, Eleni Spathi, Paris Pappas and Stavros Spiliopoulos Pages 4648 - 4655 ( 8 )
Iodinated Contrast Media (CM) has a plethora of applications in routine non-invasive or percutaneous invasive imaging examinations and therapeutic interventions. Unfortunately, the use of CM is not without complications, with contrast-induced acute kidney injury (CI-AKI) being among the most severe.
CI-AKI is a syndrome defined as a rapid development of renal impairment after a few days of CM endovascular injection, without the presence of any other underlying related pathologies. Although mostly transient and reversible, for a subgroup of patients with comorbidities related to renal failure, CI-AKI is directly leading to longer hospitalization, elevated rates of morbidity and mortality, as well as the increased cost of funding. Thus, a need for classification in accordance with clinical and peri-procedural criteria is emerged. This would be very useful for CI-AKI patients in order to predict the ones who would have the greatest advantage from the application of preventive strategies. This article provides a practical review of the recent evidence concerning CI-AKI incidence, diagnosis, and sheds light on prevention methods for reducing contrast use and avoiding AKI during endovascular procedures. In conclusion, despite the lack of a specific treatment protocol, cautious screening, assessment, identification of the high-risk patients, and thus the application of simple interventions -concerning modifiable risk factors- can significantly reduce CI-AKI risk.Contrast-induced acute kidney injury, prevention, risk score, chronic kidney disease, iodinated contrast media, high-risk patients.
Department of Radiology, Division of Interventional Radiology, “Laiko” General Hospital, 11527 Athens, Department of Radiology, Division of Interventional Radiology, School of Medicine, National and Kapodistrian University of Athens, "Attikon" University General Hospital, Athens, Department of Radiology, “Elena Venizelou” General Maternal Hospital, 11521 Athens, Department of Radiology, Division of Interventional Radiology, “Laiko” General Hospital, 11527 Athens, Department of Radiology, Division of Interventional Radiology, School of Medicine, National and Kapodistrian University of Athens, "Attikon" University General Hospital, Athens