Contrast-induced acute kidney injury: the dark side of cardiac catheterization

The rapidly growing number of percutaneous coronary interventions has led to a considerable improvement
in the outcome of patients with acute coronary syndromes, yet concurrently exposing patients to
enormous volumes of contrast media with the inherent risk of renal function impairment. The issue of
contrast-induced acute kidney injury (CI-AKI) is not only associated with direct sequelae such as prolonged
hospital stay, but also with increased risk of chronic kidney disease, recurrent acute coronary
syndromes, cerebral ischemia, and increased mortality rate. The ubiquitous application of contrast media
warrants active search for reliable risk factors, diagnostic markers, preventive measures, and therapeutic
modalities that could be used in the management of CI-AKI. The vast majority of CI-AKI incidents remain
undiagnosed due to insufficient efficiency of the serum creatinine level as the marker of acute kidney
injury. Recently, several novel renal injury biomarkers have been proposed to facilitate early diagnosis of
CI-AKI and better reflect the complex interplay between kidney and cardiac pathology, known as cardiorenal
syndrome. This review aimed to summarize the contemporary knowledge on predictors, markers,
prevention strategies, and management of CI-AKI.