Renal failure and iodinated contrast media. A review.

Contrast medium-induced renal failure is reported to be a very frequent adverse effect (up to 70% incidence) that often goes undetected. Consequences are sometimes very dramatic and can even lead to irreversible renal damage and renal dialysis. Basically, four groups of mechanisms will be considered: decrease of renal perfusion and increased vascular resistance, glomerular injury, tubular injury, and obstructive nephropathy. Many risk factors are discussed, but the most important is believed to be preexisting renal insufficiency. Preventive measures are discussed. Principally, maintaining good hydration of the patient and avoiding supplementary risk factors in excess of a possible preexisting renal damage are advocated.