PT - JOURNAL ARTICLE AU - Ilan Goldenberg AU - Shlomi Matetzky TI - Nephropathy induced by contrast media: pathogenesis, risk factors and preventive strategies AID - 10.1503/cmaj.1040847 DP - 2005 May 24 TA - Canadian Medical Association Journal PG - 1461--1471 VI - 172 IP - 11 4099 - http://www.cmaj.ca/content/172/11/1461.short 4100 - http://www.cmaj.ca/content/172/11/1461.full SO - CMAJ2005 May 24; 172 AB - WITH THE INCREASING USE OF CONTRAST MEDIA in diagnostic and interventional procedures, nephropathy induced by contrast media has become the third leading cause of hospital-acquired acute renal failure. It is also associated with a significant risk of morbidity and death. The current understanding of the pathogenesis indicates that contrast-medium nephropathy is caused by a combination of renal ischemia and direct toxic effects on renal tubular cells. Patients with pre-existing renal insufficiency, diabetes mellitus and congestive heart failure are at highest risk. Risk factors also include the type and amount of contrast medium administered. Therapeutic prevention strategies are being extensively investigated, but there is still no definitive answer. In this article, we review the current evidence on the causes, pathogenesis and clinical course of contrast-medium nephropathy as well as therapeutic approaches to its prevention evaluated in clinical trials.