Contrast-Associated Acute Kidney Injury

C ontrast-associated decrease administration in kidney of iodinated function acute that contrast kidney occurs material. within injury days In is the characterized after 1950s, the intravascular initial cases by a were reported in patients with preexisting kidney disease who were undergoing intravenous pyelography with contrast agents that were associated with a high incidence of acute kidney injury and other adverse effects.1-4 Over time, an evolution in the design of contrast agents, improved recognition of risk factors, and implementation of preventive care resulted in lower rates of acute kidney injury after the administration of contrast material5-7 (Fig. 1). More recent studies have suggested that the risk of acute kidney injury due to contrast material is overestimated.9-13 Such studies are important, considering that angiographic procedures may be underused in patients with chronic kidney disease who present with conditions such as acute coronary syndromes, presumably because of concern about precipitating acute kidney injury.14 This review summarizes the pathophysiology of contrast-associated acute kidney injury, the diagnostic criteria, and risk stratification; discusses current controversies regarding the incidence of this condition; and highlights studies that have provided the evidence that forms the basis for preventive care. Copyright © 2019 Massachusetts Medical Society.