Core IM: Pearls on Contrast-Induced Nephropathy


Definition: 
 • no slam dunk criteria 
 • definition in research studies 

typically increase in serum 

creatinine 25-50% within 

48-72 hours after contrast 

exposure 

Pathogenesis:
 • no clear explanation 
 • best data from animal 

models suggests 

hypoxic/cytotoxic acute 

tubular necrosis 

Diagnosis:
 • look for signs of ATN (muddy 

brown casts) 
 • FENa (counterintuitive, 

but sensitivity —100%) 

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