Contrast-induced Acute Kidney Injury

Abstract

The procedural use of contrast media has increased, but with it the potential risk of developing contrast-induced acute kidney injury (CIAKI). The most important risk for CIAKI is chronic kidney disease (CKD), an affliction with continually increasing incidence in modern society. The current prevalence of CIAKI is difficult to estimate because most victims are asymptomatic. The first Japanese guidelines regarding contrast agent examinations were recently announced, but their only recommendation is to provide classic fluid replacement, with saline 6–12 h before and after the contrast procedure. According to a review summarizing the recent literature, little evidence supports this suggestion. In order to diagnose early and treat emergent patients, it is appropriate to perform procedures using contrast media, even without knowledge of patients' renal function. Prevention is the most important consideration for CIAKI, and the usefulness of risk scores predicting the development of CIAKI has been reported. However, no prospective studies have been performed to date, and therefore, they will be necessary in the future. Furthermore, the development of novel preventative interventions for CIAKI is also required.