Contrast Induced Nephropathy!

PGY1 PGY2 PGY3 PGY4 Radiology

Is it real? we had this discussion before: Aortic dissection and contrast, Vertebral artery dissection and contrast, any VTE disease and contrast. but what should be our target GFR, Cre? American College of Radiology onContrast Media in 2015
“At the current time, there is very little evidence that IV iodinated contrast material is an independent risk factor for AKI in patients with eGFR ≥30 mL / min/1.73m2. Therefore, if a threshold for CIN risk is used at all, 30 mL / min/1.73m2 seems to be the one with the greatest level of evidence . Any threshold put into practice must be weighed on an individual patient level with the benefits of administering contrast material.”

they also mentioned” As previously stated, no serum creatinine or eGFR threshold is adequate to stratify risk for patients with AKI because serum creatinine in this setting is unreliable. However, in patients with AKI, theadministration of iodinated contrast medium should only be undertaken with appropriate caution, and only if the benefit to the patient outweighs the risk. There have been no published series demonstrating that IV iodinated contrast medium administration to patients with AKI leads to worse or prolonged renal dysfunction than would occur in a control group. However, patients with AKI are particularly susceptible to nephrotoxin exposure and therefore it is probably prudent to avoid intravascular iodinated contrast medium

in these patients when possible.”