REVIEW ARTICLE NEPHROTOXICITY OF CONTRAST MEDIA FOLLOWING CARDIAC ANGIOGRAPHY: PATHOGENESIS, CLINICAL COURSE, AND PREVENTIVE MEASURES, INCLUDING THE ROLE OF LOW-OSMOLALITY CONTRAST MEDIA

factors, pathogenesis and prevention of contrast-associated nephropathy (CAN) following cardiac angiography with emphasis on differences between high-osmolality contrast media (HOCM) and low-osmolality contrast media (LOCM). DATA SOURCES: Investigations in animal models and in patients following cardiac angiography. DATA EXTRACTION: Animal models of the pathogenesis of CAN are presented. Human studies describing the incidence, clinical course, risk factors, and prevention of CAN are reviewed. Comparative clinical trials of HOCM (diatrizoate, metrizoate) and LOCM (iohexol, iopamidol, ioxaglate) nephrotoxicity following cardiac angiography are critically evaluated. DATA SYNTHESIS: All clinical studies comparing CAN of HOCM versus LOCM following cardiac angiography have some methodologic limitations (e.g., small sample size, lack of control fo