What Is the Natural History of Contrast Agent induced Nephropathy?
In the vast majority of cases, contrast agent induced nephropathy will be manifest by a transient increase in serum creatinine level, which usually peaks at 4 7 days and gradually returns to baseline. A persistent elevation of serum creatinine level is unusual, as is progression to end-stage renal disease (8,17). The risk of either of these endpoints increases as a direct function of the severity of a patient s underlying renal failure; that is, most patients who require dialysis after contrast agent injection had very poor renal function at baseline. In one study of over 600 patients with elevated serum creatinine levels who underwent cardiac catheterization, only seven patients required dialysis, and permanent dialysis was necessary in only three of these (8).
