contrastinduced

Contrast-induced is a term used to describe adverse effects attributed to contrast agents used in diagnostic imaging. The most clinically significant manifestation is contrast-induced nephropathy, also known as contrast nephrotoxicity or contrast-induced acute kidney injury (CI-AKI). CI-AKI is typically defined by a rise in serum creatinine within 24 to 72 hours after contrast administration, such as an increase of ≥0.3 mg/dL or ≥50% from baseline, though definitions vary by guideline.

Contrast media fall into two main types: iodinated contrast media used for computed tomography and angiography, and gadolinium-based contrast agents used for magnetic resonance imaging. While modern gadolinium agents carry a lower risk in most patients, there remains concern for nephrogenic systemic fibrosis in those with very advanced kidney disease. The most common and studied risk is CI-AKI, but other organ- or system-specific adverse effects are possible, though rare.

Pathophysiology is multifactorial, involving renal vasoconstriction and medullary hypoxia, direct tubular toxicity, and oxidative stress, which together can impair renal function after exposure. Risk factors include preexisting kidney disease, diabetes, dehydration, advanced age, heart failure, high or repeated contrast doses, and use of certain nephrotoxic drugs (e.g., NSAIDs, aminoglycosides, diuretics, or renin–angiotensin system inhibitors).

Prevention focuses on risk assessment, adequate hydration, using the lowest effective contrast dose, and choosing iso-osmolar or low-osmolar agents when possible. Alternatives to contrast-enhanced imaging should be considered if feasible. Management is supportive, with attention to avoiding further nephrotoxins and monitoring renal function; dialysis is rarely required. Prognosis is generally favorable in people with preserved baseline kidney function, but CI-AKI can lead to longer hospitalization and, in high-risk individuals, persistent kidney injury.