Radiology: Volume 277: Number 3 - December 2015 Reviews and Commentary: Controversies
Robert J. McDonald, MD, PhD; Jenifer S. McDonald, PhD; Jeffrey H Newhouse, MD; Matthew S. Davenport, MD
Intravascular iodinated contrast material has been casually associated with the development of subsequent acute kidney injury, termed contrast material-induced nephropathy (CIN), or, more specifically, postcontrast acute kidney injury, for more than 60 years (1-3). As recently as 2010, exposure to iodinated contrast material had been implicated as the third most common cause of acute kidney injury and was reported to significantly increase the risk of dialysis and death (4,5). Although the casual association between exposure to intravenous contrast material and nephrotoxicity has been considered by many to be incontrovertible, recent debate and clinical evidence have emerged that cause us to question the incidence, severity, and in some cases existence of CIN (6-8). Iodinated contrast media are among the most commonly prescribed agents in current medical practice, with more than 30 million doses administered annually (9). It is, therefore, essential that the highest-quality evidence be obtained to understand the true incidence and clinical relevance of CIN.