Radiologic contrast-induced renal failure.

RCIRF is a complex syndrome resulting in acute renal dysfunction following exposure to radiologic contrast media. It accounts for 10 per cent of all cases of acute renal failure. The pathogenesis appears multifactorial but most probably involves contrast-mediated renal ischemia and direct tubular toxicity. Significant risk factors include preexisting renal insufficiency, diabetes mellitus, advanced age, volume depletion, and presence of multiple myeloma. The diagnosis should be suspected with acute renal dysfunction temporally related to radiologic contrast administration. The prognosis for recovery is good in most cases. Key preventive measures include identification of high-risk patients, ensuring adequate hydration prior to contrast agent administration, avoiding excessive and repeated contrast exposure, and instituting prophylactic therapy in selected cases.