Wednesday, 10 November 2010

MRCP revision battle 45.6: Radio-contrast nephropathy

Radiocontrast nephropathy complicates up to 10% of procedures involving contrast.

Contrast nephropathy presents as non-oliguric acute renal failure 1 to 5 days post procedure.

Risk of contrast nephropathy can be reduced by:
  • good hydration/normal saline
  • oral n.acetyl cysteine

Risk of contrast nephropathy is increased by:
  • increased amount of contrast
  • hypovolaemia
  • myeloma
  • increasing age
  • diabetes
  • raised calcium
  • chronic renal failure

Remember that metformin must be withheld before and for 48 hrs post IV contrast due to risk of lactic acidosis. 

Now to end on a high with a battle with minimal change disease...