ABSTRACT
With the advent of radiocontrast media (RCM) diagnostic radiology was advanced tremendously. However, despite ongoing refinement of these agents, the risk of contrast nephropathy (CN) remains present. Athough risk factors for CN have been elucidated, there have been few advances in prevention or treatment other than adequate prehydration and continued hydration after administration. In early reports, the third most common cause of hospital-acquired acute renal failure resulted from use of high-osmolar RCM for imaging studies (Shusterman et al., 1987). In more-recent analyses, this has become less common (Quader et al., 1998), however, it is not yet a rare occurrence. In spite of the current availability and use of low-osmolar RCM, acute renal dysfunction or failure continues to be observed in the hospital setting following radiographic studies (Lasser et al., 1997; Quader et al., 1998; Shusterman et al., 1987). Moreover, the number of reactions reported to the Food and Drug Administration that relate to the use of lowosmolar RCM are fourfold greater than for high-osmolar agents (Lasser et al., 1997), however there is an ever increasing number of radioimaging studies being performed in critically ill patients.
