Radiographic Contrast-Media-Induced Acute Kidney Injury: Pathophysiology and Prophylactic Strategies

Figure 1

Major mechanisms of CI-AKI: CM effects that primarily affect the nephron are depicted in blue (see stylized nephron with glomeruli, tubules, and collecting duct at the far right), effects that primarily affect blood perfusion and tissue oxygenation are depicted in red (see stylized vasculature including afferent and efferent arterioles, tufts of glomerular capillaries, peritubular capillaries, and descending vasa recta (DVR) at the far left), and CM properties and effects that affect both are in pink. The orange arrows indicate a feedback that may result in a vicious cycle: medullary hypoxia aggravates cellular damage that, by several factors, increases vasoconstriction (reproduced with permission [23]).