Contrast-Induced Nephropathy in Cardiovascular Interventions
Summary
Contrast-Induced Nephropathy (CIN), also known as contrast-associated acute kidney injury, refers to a sudden decline in renal function following intravascular administration of iodinated contrast media during cardiovascular procedures such as coronary angiography and percutaneous coronary intervention. The condition arises from a combination of medullary ischaemia, direct tubular toxicity and the generation of reactive oxygen species. Patients with chronic kidney disease, diabetes mellitus, congestive heart failure or advanced age are at highest risk. CIN contributes to increased morbidity, extended hospital stays and progression to chronic kidney disease or end-stage renal disease. Current management strategies focus on careful risk stratification, optimisation of periprocedural hydration, minimisation of contrast volume and investigation of pharmacological prophylaxis. Technological refinements in imaging and evolving procedural techniques aim to balance diagnostic accuracy with renal safety, reflecting a multidisciplinary effort to reduce the global burden of this iatrogenic complication.
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Contrast-Induced Nephropathy in Cardiovascular Interventions publication trend
The graph below shows the total number of articles in contrast-induced nephropathy in cardiovascular interventions across all publications each year (not limited to Nature Index journals).
Technical terms
Contrast-Induced Nephropathy (CIN): Acute deterioration of kidney function occurring within 48–72 hours after intravascular administration of iodinated contrast media that cannot be attributed to other causes.
Acute Kidney Injury (AKI): A rapid reduction in renal excretory function, often defined by an abrupt rise in serum creatinine or decrease in urine output.
Estimated Glomerular Filtration Rate (eGFR): A calculated measure of kidney filtering capacity based on serum creatinine, age, sex and other factors, used to assess renal function.
Percutaneous Coronary Intervention (PCI): A catheter-based procedure to relieve coronary artery stenosis, commonly involving balloon angioplasty and stent deployment.
Reactive Oxygen Species (ROS): Chemically reactive molecules containing oxygen that can cause cellular damage and play a role in the pathogenesis of nephrotoxicity.
References
- Inorganic nitrate benefits contrast-induced nephropathy after coronary angiography for acute coronary syndromes: the NITRATE-CIN trial. European Heart Journal (2024).
- Safety of metformin continuation in diabetic patients undergoing invasive coronary angiography: the NO-STOP single arm trial. Cardiovascular Diabetology (2023).
- A novel explainable online calculator for contrast-induced AKI in diabetics: a multi-centre validation and prospective evaluation study. Journal of Translational Medicine (2023).
- Side Effects of Radiographic Contrast Media: Pathogenesis, Risk Factors, and Prevention. BioMed Research International (2014).
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