Relationship between contrast administration and acute kidney injury in patients undergoing contrast versus non-contrast tomography : An overview study

Abstract

Iodinated contrast agents are a crucial component as a complement in tomographic studies since they allow characterizing multiple clinical conditions. However, the use of these drugs is not completely innocuous, with renal damage being the most common complication and the main cause of acute renal injury in hospitalized patients (1). This complication is increasingly frequent due to the greater availability of studies with iodinated contrast agents, and it is usually the population with multiple comorbidities that is subject to this type of procedure in greater proportion. In addition, renal damage has been shown to be related to prolonged hospital stays and in-hospital mortality, as well as increased health costs (2). In 2012, the KDIGO (Kidney Disease Improving Global Outcomes) group coined the term contrastinduced acute kidney injury for the first time, defining it as an impairment of renal function typically in the first 48 hours after a procedure with the use of iodinated contrast medium, evidenced by an increase in serum creatinine by 0.5 mg/dL or an increase of 25% of the basal value, usually between the 2nd and 5th day after the procedure and that can remain for 14 to 21 days, until normalization to the patient's usual creatinine value (3), this is usually the most used definition but not the only one that has been proposed, more recent criteria established by guidelines of European and North American radiology societies, define it as an increase in serum creatinine of at least 0. 3 mg/dL or 1.5 times above the baseline level within 48-72 hours of intravascular administration of a contrast medium. Additionally, it has been described that up to 30% of patients remain with some degree of renal function alteration, among these approximately 1% will require dialytic therapy (4).