Reducing the risk of contrast-induced nephropathy: a perspective on the controversies.

Abstract

Contrast-induced nephropathy (CIN) remains poorly understood despite decades of investigation, and the criteria for diagnosis are variable. The purpose of this article is to discuss current controversies in contrast-induced nephropathy including its prevention. Patients with normal renal function are at exceptionally low risk for CIN. Patients with preexisting renal insufficiency appear to be at higher risk and precautionary maneuvers may be warranted in some of these patients; however, iodinated contrast material should not be withheld if a contrast-enhanced study is necessary and there is no alternative.