What causes contrast nephrotoxicity in the workup of renal artery stenosis (RAS)?

Updated: Nov 02, 2020
  • Author: Bruce S Spinowitz, MD, FACP; Chief Editor: Vecihi Batuman, MD, FASN  more...
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Answer

Patients with progressive ischemic nephropathy (ie, underlying chronic renal failure) are at risk for contrast nephrotoxicity and should be informed of this risk prior to any contrast procedure.

Contrast nephropathy typically manifests as a brief rise in the serum creatinine level 3-6 days after exposure to radiocontrast and is reported in up to 40% of patients with underlying renal failure.

Most patients with contrast nephropathy ultimately recover renal function. Porter reviewed results from nearly 300 patients with contrast nephropathy and concluded that fewer than 10% of these patients required dialysis permanently.


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