Contrast Medium Administration in the Elderly Patient: Is Advancing Age an Independent Risk Factor for Contrast Nephropathy after Angiographic Procedures?

• Published in: Journal of vascular and interventional radiology Vol. 18; no. 2; pp. 177 - 185
• Main Authors: Detrenis, Simona, MD, Meschi, Michele, MD, Bertolini, Laura, MD, Savazzi, Giorgio, MD
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.02.2007
• Subjects: Age Factors; Aged; Aging - physiology; Contrast Media - administration & dosage; Contrast Media - adverse effects; Creatinine - blood; Creatinine - urine; Glomerular Filtration Rate - physiology; Humans; Kidney - physiopathology; Kidney Diseases - chemically induced; Kidney Diseases - prevention & control; Osmolar Concentration; Radiology; Risk Factors; nonsteroidal anti-inflammatory drugs; angiotensin-converting enzyme inhibitors; glomerular filtration rate; TRBF; total renal plasma flow; low-osmolar contrast medium; CM; total renal blood flow; contrast medium–induced nephropathy; MDRD; high-osmolar contrast medium; LOCM; CMIN; HOCM; Modification of Diet in Renal Disease Study; GFR; IOCM; GBM; TRPF; contrast medium; NSAIDs; glomerular basement membrane; isoosmolar to plasma contrast medium; ACEIs
• ISSN: 1051-0443; 1535-7732
• DOI: 10.1016/j.jvir.2006.12.009

Contrast medium–induced nephropathy (CMIN) is the third leading cause of hospital-acquired acute renal dysfunction. Even if the number of patients over 75 years of age undergoing diagnostic and/or interventional procedures and requiring administration of contrast medium (CM) is growing constantly, at present there is no definitive consensus regarding the role of advancing age and related morphologic or functional renal changes as an independent risk factor for CMIN. The authors review the evidence from recent medical literature on the definition, pathophysiology, and clinical presentation of CMIN as well as therapeutic approaches to its prophylaxis. Attention is focused on advancing age as a preexisting physiologic condition that is, per se, able to predispose the patient to CM-induced renal impairment, assuming that every elderly patient is potentially at risk for CMIN.