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Contrast Induced Nephropathy (Definition (Iatrogenic renal injury, Due to:…
Contrast Induced Nephropathy
A.K.A
Contrast induced kidney injury
Definition
Iatrogenic renal injury
Due to: Intravascular administration of radio-opaque contrast media
in: SUSPECTIBLE individuals
History
Known since 1950s
Fatal acute renal failure
In patients with renal disease from Multiple myeloma
Affects:
1%-2% of general population
50% of high risk subgroups following coronary angio or PCI
CIN GRADE
Grade 0
SCr
and <0.5 mg/dL above basline
increase <25%
6 month outcomes
MACE 12.4%
Mortality 10.2%
Grade 1
SCR
Increase >= 25%
<0.5 mg/dL above baseline
6 months outcome
MACE 19.4%
Mortality 10.14%
Grade 2
SCr
Increase >= 0.5 mg/dL above baseline
6 month outcome
MACE 28.6%
Mortality 40.9%
Diagnostic criteria
25% relative increase in Cr
No Other explanation
Within 72 hour of contrast exposure
Natural history
Acute: Occuring within 2-3 days
Renal insuf
SCr level peaks in 2-5 days
Return to normal in 14 days