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BioMed Research International
Volume 2014, Article ID 859328, 6 pages
http://dx.doi.org/10.1155/2014/859328
Review Article

Contrast-Induced Acute Kidney Injury: Definition, Epidemiology, and Outcome

1Department of Radiology and Radiological Science, Medical University of South Carolina, Ashley River Tower, MSC 226, 25 Courtenay Drive, Charleston, SC 29425, USA
2Institute for Clinical Radiology, Ludwig-Maximilians-University Hospital, 81377 Munich, Germany
3Department of Radiological Sciences, Oncology and Pathology, University of Rome “Sapienza”—Polo Pontino, 04100 Latina, Italy
4Division of Cardiology, Department of Medicine, Medical University of South Carolina, Charleston, SC 29425, USA

Received 8 August 2013; Accepted 3 February 2014; Published 10 March 2014

Academic Editor: Adis Tasanarong

Copyright © 2014 Felix G. Meinel et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Contrast-induced acute kidney injury (CI-AKI) is commonly defined as a decline in kidney function occurring in a narrow time window after administration of iodinated contrast material. The incidence of AKI after contrast material administration greatly depends on the specific definition and cutoff values used. Although self-limiting in most cases, postcontrast AKI carries a risk of more permanent renal insufficiency, dialysis, and death. The risk of AKI from contrast material, in particular when administered intravenously for contrast-enhanced CT, has been exaggerated by older, noncontrolled studies due to background fluctuations in renal function. More recent evidence from controlled studies suggests that the risk is likely nonexistent in patients with normal renal function, but there may be a risk in patients with renal insufficiency. However, even in this patient population, the risk of CI-AKI is probably much smaller than traditionally assumed. Since volume expansion is the only preventive strategy with a convincing evidence base, liberal hydration should be encouraged to further minimize the risk. The benefits of the diagnostic information gained from contrast-enhanced examinations will still need to be balanced with the potential risk of CI-AKI for the individual patient and clinical scenario.