Iodinated Contrast and Renal Insufficiency
Contrast induced nephropathy (CIN) is usually defined as impairment in renal function occurring within 3 days following intravascular administration of a contrast agent, in the absence of an alternative etiology. In most patients with CIN, renal impairment is maximal 3 days following contrast administration, and spontaneously recovers over a period of 14 days. The most common risk factor for CIN is chronic renal failure. CIN is more likely to occur with high doses (> 125mL) of iodinated contrast.
At Hunter Radiology we take a conservative approach to patients with renal disease. All patients who require Iodinated Contrast are given a questionaire outlining their risk factors for the injection.
Any patients who have a history of renal disease have their latest blood test results reviewed.
Patients with a GFR > 60 are given contrast where needed.
Patient with a GFR between 40 and 60 are checked for additional risk factors and the necessity for using iodinated contrast. If given the contrast volume is reduced and the patients are given 1L of fluid prior to the examination and are told to drink 2-3 Litres of water in the 24 hours following the examintion.
Patients with a GFR <40 are reviewed on a case by case basis for the necessity of contrast and other risk factors. These cases are best discussed between the Radiologist and the Referring Physician.
For more information see the RANZCR GUIDELINES FOR IODINATED CONTRAST ADMINISTRATION