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.
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The IBCC chapter is located here.
- The podcast & comments are below.
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References
- PulmCrit Blogitorial – Use of ECGs for management of (sub)massive PE - March 24, 2024
- PulmCrit Wee: Propofol induced eyelid opening apraxia – the struggle is real - March 20, 2024
- PulmCrit wee: Why I like central lines for GI bleed resuscitation - March 13, 2024
I just admitted a patient with chf and stage 3 cki to my surgical ICU for the second time because of massive pleural effusions and congestion. He was “watered” with 2 liters /day for his scan…
Thank you very much for your post and greetings from Germany
Thanks so much for your post! I remember countless hemorrhagic stroke patients that I took care of at RR UCLA MC and that “bump” in creatinine would always come up and MD’s would way the risk of HCT with vs w/o contrast. I wish I knew this information back then.