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There is an ever-increasing frequency in the use of radiocontrast media (RCM) in diagnostic radiology such as angiography, large-dose excretory urography, contrast-enhanced computerized automated tomography, digital subtraction arteriography, etc. This has raised the important issue which concerns most clinical nephrologists relating to the likelihood of a proportional rise in RCM-induced acute renal failure (ARF). Currently available data regarding the actual incidence of RCM-induced ARF are conflicting (1,2). Certain risk factors which may favour the development of RCM-induced ARF have been proposed, such as old age; renal parenchymal disease; diabetes mellitus; cardiac failure; dehydration; the dose, frequency and method of administration of RCM (3). In the presence of such risk factors, the development of ARF with the use of RCM could evolve from one or both of the following mechanisms:— a) Renal vasoconstriction with prolonged ischaemia leading to acute tubular necrosis (4), or b) Direct nephrotoxic effect (2, 3). |
