Contrast Induced Nephropathy in ICU settings

Contrast-Induced Nephropathy (CIN) is defined as acute deterioration of renal function after the administration of Radio-contrast materials, mostly within a period of 24 to 48 hours. Most of cases are non-oliguric and reversible and rarely associated with adverse outcomes. The diagnosis of CIN is based upon the clinical presentation, including the characteristic rise in serum creatinine concentration beginning with the first 24 to 48 hours after contrast exposure, and the exclusion of other causes of acute kidney injury (AKI). Incidence of CIN varies widely depending on the definition of AKI, the presence or absence of risk factors, the amount and type of agent administered, and the type of radiologic procedure. Biomarkers Cystatin C, Neutrophil gelatinase-associated lipocalin (NGAL) in urine and plasma, 2 hr after contrast administration have been shown to be predictive biomarkers of CIN. Most cases of CIN are self-limited. Management is conservative as with any other case of AKI and dialysis is rarely required. Adequate hydration, use of low doses of contrast media especially low-osmolar or iso-osmolar type , will reduce the risk of CIN.