Contrast-Induced Nephropathy

Diagnosis and treatment of cardiovascular diseases often require the administration of iodinated contrast media. However, it is sometimes difficult to use such contrast media in patients with renal dysfunction because direct mechanisms of tubular cell injury and indirect mechanisms of medullary ischemia, together with the contrast medium, may cause contrast-induced nephropathy (CIN). Although the frequency of developing CIN is said to be lower than previously estimated, once it develops, there is no effective treatment, and it may affect mortality. Therefore, before using a contrast medium, it is necessary to identify the risk factors of CIN in patients—including chronic kidney disease, advanced age, and diabetes mellitus—and understand the risk differences between intravenous and intra-arterial contrast medium administration. If there is any risk, intravenous saline or sodium bicarbonate treatments may be used to prevent CIN onset, and the use of minimum amounts of contrast media, within the corresponding range, may be recommended. (This is a translation of Jpn J Vasc Surg 2024; 33: 143–147.)