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Gary C. Curhan, MD, ScD

JAMA. 2003;289:606-608.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

Contrast nephropathy is one of the well-recognized risks of coronary angiography. Although the disease occurs infrequently with normal renal function, its frequency increases with decreasing renal function, ranging from 5% in patients with mild renal insufficiency¹ to 50% in those with severe renal dysfunction and diabetes.² Given that contrast nephropathy is associated with increased morbidity, mortality, and length of hospitalization, and possibly with long-term renal impairment,³ there is great interest in its prevention.

Several factors increase the risk of contrast nephropathy. Contrast-related factors include higher total dose and the use of ionic and high osmotic agents.³ Patient-related risk factors include renal dysfunction, diabetes mellitus, congestive heart failure, and reduced effective circulating volume.³

The mechanism by which contrast adminstration leads to renal injury is uncertain. Studies in humans suggest 2 potential pathways that may operate individually or together: renal vasoconstriction, resulting in medullary ischemic damage, and . . . [Full Text of this Article]

Author Affiliations: Channing Laboratory, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Mass.

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