Acute renal failure post IV contrast injection: CT findings

Case contributed by Dr Chris O'Donnell

Presentation

Acute renal failure (anuria) 48 hours post IV radiographic contrast injection for assessment of disseminated malignancy. eGFR of 35.

Patient Data

Age: 75 years
Gender: Male

CT scan performed 2 days later prior to biopsy, no IV contrast administered

CT

Residual contrast in the renal parenchyma but not the collecting systems without contrast in other organs or blood vessels despite isolated IV contrast injection 2 days previously.

Widespread malignancy with relatively normal kidneys showing contrast enhancement

Case Discussion

Contrast-induced acute kidney injury (CI-AKI) is uncommon and usually in patients with pre-existing renal dysfunction (ie eGFR < 30), dehydration and/or large volume contrast injection (> 300mls at one sitting) such as my occur in cardiac, vascular or neuro-interventional procedures.

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