step by step approach to prevent lodinated contrast-media induced acute kidney injury [ICI-AKI] in hospital inpatients

ABSTRACT

Chronic kidney disease is one of the biggest health threats facing the world, the State of Qatar being no exception. In Qatar the annual incidence of end-stage renal disease is approximately 200 per million of population. This figure is expected to rise further, reflecting the global epidemic of Type 2 diabetes and the ageing of the population. Advances in medical care have led to an increased number of iodinated contrast media [ICM] based radiographic studies and interventions. In the last few years, there has been an intense focus on Nephrogenic Systemic Fibrosis and consequently the medical community has almost abandoned the use of gadolinium based radio contrast agents in patients with advanced renal impairment. Hence, ICM remain the mainstay for diagnostic and interventional radiological procedures. As kidney disease and diabetes are major risk markers for iodinated contrast media induced acute kidney injury [ICI-AKI], one can predict that the burden of ICI-AKI will increase. A practical step-by-step management algorithm is presented which is intended to promote safe administration of intravascular ICM in hospital inpatients at risk of ICI-AKI