[Radiographic Contrast Nephropathy]

Iodinated radiographic contrast media may cause kidney dysfunction that occurs in particular in patients with pre-existing renal impairment and/or diabetes. This impairment of renal function is called contrast-induced nephropathy (CIN), i.e. an acute renal failure occurring within 24-72 hours after the intravascular injection of iodinated radiographic contrast media that cannot be attributed to other causes. The pathogenesis of CIN has not been fully elucidated yet. It may be due to several factors, including renal ischaemia, particularly in the renal medulla, formation of reactive oxygen species (ROS), reduction of nitric oxide (NO) production, tubular epithelial and vascular endothelial injury. CIN can be prevented. For prevention, however, we need to know the risk factors. I have reviewed the pathogenesis and the risk factors for CIN and discussed the measures for its prevention, providing a long list of references which will allow readers to evaluate deeply this iatrogenic disease.