Does contrast nephropathy exist? Vigorous debate has been ongoing about this dating back to 2013.1 Hundreds of studies on the topic ultimately reveal no convincing evidence that contrast nephropathy exists. However, it's unethical to perform a prospective RCT, so it's impossible to ever prove this. This has left us in an evidentiary limbo – we don't really believe that contrast nephropathy exists, but simultaneously we are also afraid of it.
— Matt Sztajnkrycer (@NoobieMatt) April 21, 2019
Where do we go from here? I queried the twittersphere to see if anyone was aware of high-quality evidence supporting contrast nephropathy. Nobody was.
I've been following this topic with interest since my blog in 2015 on it (which found little evidence to support the concept). Four years of cautiously weighing the evidence and waiting for new data seems like enough. As most folks on twitter felt, it's time to move beyond this dogma.
The IBCC chapter is located here.
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- IBCC chapter:Guide to APRV for COVID-19 - April 8, 2020
- PulmCrit Theoretical Post – The COVID Severity Index (CSI 1.0) - April 2, 2020
- PulmCrit wee – Why the SCCM/AARC/ASA/APSF/AACN/CHEST joint statement on split ventilators is wrong. - March 29, 2020