Macaulay Amechi Onuigbo
1,2*, Eileen Samuel
2, Nneoma Agbasi
31 Mayo Clinic College of Medicine, Rochester, MN, USA
2 Department of Nephrology, Mayo Clinic Health System, Eau Claire, WI, USA
3 North East London NHS Foundation Trust, United Kingdom
Abstract
In the cognate nephrology literature, a few recent publications from major academic centers in
the United States have suggested that the incidence of contrast nephropathy was exaggerated
and overstated. These investigators have concluded that intravenous contrast material
administration was not associated with an increased risk of acute kidney injury (AKI),
emergent dialysis, and short-term mortality in a cohort of patients with diminished renal
function. As a contrarian opinion, we first describe a clear cut case of contrast-nephropathy
resulting in AKI requiring hemodialysis treatment managed in the Renal Unit of the Mayo
Clinic Health System, Northwestern Wisconsin, in the Spring of 2017. We subsequently
revisit the overwhelming evidence-base in the English literature that supports the enormous
impact of contrast-nephropathy as a clinical syndrome. We finally posit that these recent
repudiations of the existence and significance of contrast-nephropathy as a significant clinical
entity represent an overreach in statistical expertise. There is no basis for a requiem song over
contrast-nephropathy
Implication for health policy/practice/research/medical education:
Recently in the cognate nephrology literature, there has been a spate of publications suggesting that contrast nephropathy
is an exaggerated and overstated reality. Indeed, some investigators have lately concluded that intravenous contrast material
administration was not associated with an increased risk of acute kidney injury (AKI), emergent dialysis, and short-term
mortality in a cohort of patients with diminished renal function. We describe a clear cut case of contrast-nephropathy resulting
in AKI requiring hemodialysis treatment managed in the Renal Unit of the Mayo Clinic Health System, Northwestern Wisconsin,
in the Spring of 2017, and subsequently revisit the overwhelming evidence in support of the enormous impact of contrastnephropathy
as a clinical syndrome in the nephrology literature. We submit that these recent repudiations of the existence of
contrast-nephropathy as a significant clinical entity represent an overreach. There is no basis for a requiem song over contrastnephropathy.
Please cite this paper as: Onuigbo MA, Samuel E, Agbasi N. The demise of contrast nephropathy; can this be true? A contrarian
view; a representative case report of contrast nephropathy from Mayo Clinic Health System in Northwestern Wisconsin. J
Nephropharmacol. 2018;7(2):68-73.