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Chapter 19: Renal Complications of Contrast Media

Anand Prasad; Peter A. McCullough

Chapter 19. Renal Complications of Contrast Media

Which of the following statements is true about contrast-induced acute kidney injury (CI-AKI)?

A. It is the most common cause of hospital-acquired renal failure.

B. The incidence of CI-AKI is well defined in the literature and is approximately 20%.

C. One percent of episodes of CI-AKI require dialysis.

D. Episodes of CI-AKI not requiring dialysis add, on average, 7 days to the hospitalization.

The correct answer is C

Which of the following statements is true about transient rises in serum creatinine following contrast administration?

A. Changes >0.1 mg/dL are considered significant.

B. A rise of >0.3 mg/dL in serum creatinine occurs in approximately 7% of patients undergoing percutaneous coronary intervention (PCI).

C. Transient rises in serum creatinine have not been associated with adverse long-term outcomes.

D. Definitions of CI-AKI have had consistent criteria with respect to acute changes in serum creatinine.

The correct answer is B

Which of the following statements is true about biomarkers for CI-AKI?

A. Tubular markers for AKI, including liver-type fatty acid binding protein, kidney injury molecule-1, and neutrophil gelatinase-associated lipocalin, have improved sensitivity for renal injury as compared to serum creatinine.

B. Serum creatinine changes provide rapid detection of renal injury following contrast administration.

C. Cystatin C is a tubular marker that is upregulated during AKI.

D. Changes in urine creatinine levels are more reliable than serum creatinine for AKI.

The correct answer is A

Which of the following occurs after contrast administration?

A. Prolonged renal vascular vasodilation

B. A brief increase in renal blood flow followed by prolonged vasoconstriction

C. No acute changes in renal perfusion

D. An acute decline in renal vein renin levels

The correct answer is B

Which of the following statements is true about management and prevention of CI-AKI?

A. Metformin-induced lactic acidosis is most common in non–insulin-dependent diabetics with underlying renal dysfunction.

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