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What is Which of the following will have a contrast nephropathy? and explain in detail?
Ans. (a) Diabetic NephropathyRef : Harrison 18th edition, Chapter 279* Iodinated contrast agents used for cardiovascular and CT imaging are a leading cause of AKI. The risk of AKI, or "contrast nephropathy," is negligible in those with normal renal function but increases markedly in the setting of chronic kidney disease, particularly diabetic nephropathy.* The most common clinical course of contrast nephropathy is characterized by a rise in SCr beginning 24-48 hours following exposure* peaking within 3-5 days, and resolving within 1 week.* Contrast nephropathy is thought to occur from a combination of factors# Hypoxia in the renal outer medulla due to perturbations in renal microcirculation and occlusion of small vessels# Cytotoxic damage to the tubules directly or via the generation of oxygen free radicals, especially since the concentration of the agent within the tubule is markedly increasedTransient tubule obstruction with precipitated material.