Contrast-induced nephropathy in patients with kidney disease: new considerations on osmolality, glomerular filtration rate, and clinical endpoint

Analysis by V. Matarese

 

Introduction

Contrast-induced nephropathy (CIN) has been a cause of concern for over 15 years, but recent attention has focused on CIN associated with the intravenous administration of contrast agents for multidetector CT, a more common and safer procedure than angiography with intra-arterial contrast. Three recent randomized controlled trials in patients at high risk, i.e. with chronic kidney disease and also diabetes mellitus, reported low rates of CIN (<7% in all study groups, according to all clinical endpoints). In an attempt to understand why CIN manifests in a small proportion of high-risk patients, researchers H.S. Thomsen and S.K. Morcos re-evaluated pooled data from two trials.

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