Contrast nephrotoxicity and the role of radionuclide renal scan.
Radiographic contrast media-induced nephrotoxicity is an important cause of acute renal failure. The indications of using contrast are usually unavoidable, compelling and continue to expand, especially in the vascular field. When acute renal failure follows such a procedure, it becomes important to establish the presence of contrast nephrotoxicity or an acute occlusive event which may have precipitated the failure. We present two cases of contrast nephrotoxicity in patients with impaired renal function. Radionuclide renal studies with 99mTc-DTPA (Patient 1) and 99mTc-MAG3 (Patient 2), confirmed the presence of acute tubular necrosis and excluded major occlusive vascular events. Renal scintigraphy remains an important but underused test which can rule out obvious renal vascular occlusion and/or support the diagnosis of contrast-related acute tubular necrosis, as the cause of renal failure in these patients.
Institute of Nuclear Medicine and Nephrology, Middlesex Hospital, London, United Kingdom.
R T
RT
Dhawan
M
M
Foo
J B
JB
Bomanji
F J
FJ
Setna
P J
PJ
Ell
D000368:Aged; D003287:Contrast Media / Q000009:adverse effects*; D006801:Humans; D007472:Iohexol / Q000009:adverse effects*; D007668:Kidney / Q000000981:diagnostic imaging* / Q000187:drug effects; D007683:Kidney Tubular Necrosis, Acute / Q000139:chemically induced / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D011877:Radionuclide Imaging; D017263:Technetium Tc 99m Mertiatide; D016284:Technetium Tc 99m Pentetate
D003287:Contrast Media; D017263:Technetium Tc 99m Mertiatide; D007472:Iohexol; D016284:Technetium Tc 99m Pentetate