THE EFFECT OF CONTRAST AGENTS ON RENAL-FUNCTION

Contrast agent nephropathy accounts for a substantial number of hospit al acquired incidences of acute renal failure and the functional damag e induced may sometimes be irreversible. The true incidence of the com plication is still uncertain but seems to be low in patients with norm al renal function. Among numerous risk factors proposed, pre-existing renal failure is the most important. Diabetes only seems to be a signi ficant risk when there is pre-existing renal functional deficiency. Am ong four main theories for the mechanism of contrast agent nephropathy , interest is mainly focused on post contrast vasoconstriction and dir ect tubulotoxicity of the contrast agent. No dramatic decrease in the overall incidence of contrast agent nephropathy has been observed foll owing the change from ionic to non-ionic agents. However, several rece nt clinical trials confirm that non-ionic contrast agents are less nep hrotoxic than ionic agents in patients with pre-existing renal insuffi ciency.