Predicting contrast induced nephropathy in patients undergoing percutaneous coronary intervention

Contrast induced nephropathy (CIN) is an iatrogenic renal injury that occurs following the administration of intra-vascular radio-opaque contrast media. It affects 1–2% of all patients undergoing coronary angiography procedures and accounts for a third of all in-hospital acquired kidney injuries (1). As we are now performing coronary procedures more frequently in older patients with a multitude of comorbidities, CIN is becoming increasingly relevant. Furthermore, it is not an entirely benign event. Although, in the majority of patients, the renal impairment is transient, the development of CIN has also been associated with prolonged hospitalisation, increased cardiovascular events and increased mortality at short and medium term follow up (2-4). Therefore, the ability to prospectively identify those patients at risk and take appropriate precautionary measures including a reduction in contrast volume and administration of prophylactic treatment would be advantageous.