Contrast Media Induced Nephropathy in Diabetic Nephropathy

Abstract

The potential for acute renal injury following the administration of iodinated radiocontrast media has been recognized for many years. The earliest reports were in patients with multiple myeloma [1, 2] following intravenous urography. In 1968, Bergman, Ellison, and Dunea [3] were the first to report acute renal failure in a diabetic patient following infusion urography. By 1982, our review of the literature [4] found that deterioration of renal function after radiocontrast administration had been recorded in over 100 diabetics. Hou et al. [5] in 1983 were able to attribute 12% of all hospital-acquired episodes of renal insufficiency to radiocontrast procedures (16 of 129 episodes in 2216 patients at risk). Numerous reports have appeared attempting to document the incidence, risk factors, and pathogenesis of this phenomenon. In this chapter, we will summarize current knowledge in this area, with particular attention to the diabetic patient.