special subjects
Radiographic Contrast Agents and Contrast Reactions
Contrast nephropathy
In Contrast Nephropathy , serum creatinine typically begins to increase within 24 hours after administration of IV contrast; it peaks between days 3 and 5 and returns to baseline within 7 to 10 days. Common risk factors include the following: Preexisting renal insufficiency (elevated creatinine) Diabetes Mellitus (DM) , especially in patients with associated Hypertension None Heart Failure (HF) None Multiple Myeloma None Age>70 Use of other nephrotoxic drugs Dehydration In patients at risk of Acute Kidney Injury (AKI) after receiving iodinated intravascular contrast, the following measures should be considered: A reduced dose of contrast Use of an iso-osmolar agent Hydration Many hydration regimens exist. One regimen suggests administration of normal saline at 100 mL per hour for a duration of 6 to 12 hours before the contrast administration and continued for 4 to 12 hours following the contrast injection (seeAmerican College of Radiology Manual on Contrast Media). has been widely studied and has not been shown to be effective in preventing contrast-induced nephropathy ( Reference ). 