Contrast Dye and the Kidneys (2024)

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Diagnostic tests such as MRIs, CT scans and angiograms are routinely used because they provide important information about many diseases or injuries and can help in diagnosis and treatment. In many cases, the use of a contrast dye is necessary to enhance these tests, but sometimes these dyes can either lead to kidney problems, or cause problems in patients with kidney disease. There are two rare but serious disorders associated with contrast dyes and the kidneys: contrast induced nephropathy (CIN) and nephrogenic systemic fibrosis (NSF).

What is Contrast Induced Nephropathy (CIN)?

CIN is a rare disorder and occurs when kidney problems are caused by the use of certain contrast dyes. In most cases contrast dyes used in tests, such as CT (computerized tomography) and angiograms, have no reported problems. About 2 percent of people receiving dyes can develop CIN. However, the risk for CIN can increase for people with diabetes, a history of heart and blood diseases, and chronic kidney disease (CKD). For example, the risk of CIN in people with advanced CKD (glomerular filtration rate (GFR) below 30 mL/min/1.73m2), increases to 30 to 40 percent. The risk of CIN in people with both CKD and diabetes is 20 to 50 percent.

CIN is associated with a sharp decrease in kidney function over a period of 48-72 hours. The symptoms can be similar to those of kidney disease, which include feeling more tired, poor appetite, swelling in the feet and ankles, puffiness around the eyes, or dry and itchy skin. In many cases, CIN is reversible and people can recover. However, in some cases, CIN can lead to more serious kidney problems and possible heart and blood vessel problems.

What is Nephrogenic Systemic Fibrosis (NSF)?

NSF is a rare but serious disease affecting skin and other organs that has been found in some patients with advanced CKD after exposure to gadolinium-containing contrast dyes that are used in magnetic resonance imaging (MRI). NSF appears to affect about 4 percent of patients with advanced CKD. People with acute kidney injury (AKI) are also at higher risk. NSF has not been reported in people with mild kidney damage or normal kidney function.

NSF can be painful, debilitating, or even fatal. Symptoms and signs of NSF can include burning and itching of the skin, red or dark patches on the skin, joint stiffness, or muscle weakness. The disease can develop within 24 hours up to around 3 months.

MRIs are routinely used in patients to visualize internal organs and limbs to help detect and monitor many different diseases or injuries. Contrast dyes are often used during MRI to enhance the images obtained, and these dyes contain an element called gadolinium. In people with CKD, the kidneys are not able to filter out wastes, drugs and toxins the way they normally should. In advanced CKD, the excretion of gadolinium-containing contrast dyes used in MRIs is slower than in people with normal kidney function. This delay in excretion is thought to be one the main reasons why NSF may happen.

How can I reduce my risk for CIN and NSF?

  • Know your GFR and if you have CKD. If you do not know your GFR, you can ask your doctor or healthcare professional. Your kidney function is estimated by the glomerular filtration rate, or eGFR.
  • Tell all of your healthcare professionals about your GFR and CKD, especially if a diagnostic test such as a CT scan, MRI or angiogram has been ordered. Talk to the doctor ordering the diagnostic test. You can also ask to talk to the radiologist, radiology technician and nurse.
  • If you need to have a CT scan, angiogram or MRI:
    • Ask about your risk for NSF and CIN, based any risk factors you might have:
      CIN Risk FactorsNSF Risk Factors

      Use of CT scan or angiography with contrast dye, and one or more of the following:

      • CKD
      • Diabetes
      • Heart and blood vessel problems
      • Older age

      Use of MRI with gadolinium -based contrast dye, and one of the following:

      • AKI
      • Advanced kidney disease (GFR below 30 mL/min/1.73m2)
    • Discuss the need for a contrast agent with your healthcare professional.
    • Ask about alternatives such as a test without contrast, if feasible.
  • If any of these tests with contrast dyes are necessary, ask about precautions that will be taken, including:
    • Making sure to follow any instructions before, during or after the procedure, for example drinking fluids so you are not dehydrated.
    • Asking about avoiding certain contrast dyes because of the risk of developing NSF or CIN.
    • Allowing sufficient time for elimination of contrast dye before re-administering.
    • Avoiding repeated or higher doses of contrast dye.
    • Performing long-term monitoring for CIN or NSF after a diagnostic test.
  • Know the signs and symptoms of CIN and NSF:
    CIN SymptomsNSF Symptoms
    • Feeling more tired
    • Poor appetite
    • Swelling in the feet and ankles
    • Puffiness and swelling around the eyes
    • Dry and itchy skin
    • Burning, itching, swelling, scaling, hardening and tightening of the skin
    • Red or dark patches on the skin
    • Stiffness in joints with trouble moving, bending or straightening the arms, hands, legs or feet
    • Pain in the hip bones or ribs; or muscle weakness
  • Contact your healthcare professional immediately if you experience any of these symptoms.
See Also
CT scan

Can NSF and CIN be treated?

There are no proven treatments for NSF and CIN, but symptoms may gradually improve over time. New medications are showing promising results but prevention remains key.

There are benefits to undergoing these procedures. The benefits, however, should outweigh the risks associated with the use of contrast dye. These contrast dyes have helped in the diagnosis and treatment of many patients with various diseases and injuries, so there is also a risk of not doing these procedures.

If you would like more information, please contact us.

© 2015 National Kidney Foundation. All rights reserved. This material does not constitute medical advice. It is intended for informational purposes only. Please consult a physician for specific treatment recommendations.

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Last Reviewed: 05/14/2024

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Contrast Dye and the Kidneys (2024)


Is contrast dye bad for your kidneys? ›

In many cases, the use of a contrast dye is necessary to enhance these tests, but sometimes these dyes can either lead to kidney problems, or cause problems in patients with kidney disease.

How long does it take for kidneys to recover from contrast dye? ›

Generally, it is reversible and biopsy is rarely needed for the diagnosis. CIN is normally a self-resolving process, with renal function getting back to normal within 7-14 days of the administration of contrast. Fewer than one-third of patients develop some level of residual renal impairment.

How do you protect your kidneys from contrast dye? ›

If you must have dye, your doctor may prescribe a drug called acetylcysteine to help protect your kidneys from harm. You would need to take it the day before an X-ray dye test. Talk to your care team about how much to drink before an X-ray dye test and whether to skip a water pill if you take one.

What supplement protects kidneys from contrast dye? ›

Only N-acetylcysteine clearly prevented contrast-induced nephropathy, the medical name for kidney damage caused by contrast agents. Theophylline, another drug that has been seen as a possible kidney-protecting agent, did not reduce risk significantly. Other drugs had no effect, and one, furosemide, raised kidney risk.

What are the alternatives to contrast dye for kidney disease? ›

Patients with renal disease or contrast allergy pose limitations on the use of ICM. In such cases, alternative contrast media may be used to carry out the procedure. Current alternatives include carbon dioxide, gadolinium, and dilute ICM.

Who should not get contrast dye? ›

MRI contrast is generally safe for most people. However, individuals with kidney disease and those who are pregnant should let their doctor know before getting an MRI with contrast. Common side effects of contrast materials are generally mild and may include a rash, nausea, and vomiting.

How to flush kidneys after contrast? ›

Drink plenty of water after the MRI scan to help your kidneys flush the contrast out from your body. If you become unwell during the day after your scan, go to your nearest emergency department or general practitioner (GP). The kidneys remove most MRI contrast agents from your blood.

What contrast is best for kidneys? ›

Contrast agents are injected into a vein in the hand or arm. The contrast agents used for MRI scans often contain a chemical element called gadolinium (gad-oh-LIN-e-um). Newer contrast agents that contain gadolinium are generally safe for people with kidney disease, even those who receive dialysis.

How long does contrast dye stay in your system? ›

With normal kidney function, most of the gadolinium is removed from your body in the urine within 24 hours. A small amount of the gadolinium can stay in the body. Currently all studies have found no harmful health effects from this retention. There are different types/brands of GBCA that can be used for your MRI exam.

What supplements are hardest on the kidneys? ›

Some supplements that you should avoid if you have kidney disease include supplements with:
  • Chromium picolinate.
  • Creatine monohydrate.
  • Germanium.
  • L-lysine.
  • Larrea tridentate.
  • Pausinystalia yohimbe.
  • Salix daphnoides.
  • Thunder god vine.
Nov 3, 2022

What vitamin helps your kidneys? ›

Vitamin D

Those suffering from chronic kidney disease may have low vitamin D levels primarily because damaged kidneys have difficulty converting vitamin D into its active form. Taking a vitamin D supplement may suppress the progression of chronic kidney disease and help you reach a healthy vitamin D level.

Is cheerios good for kidneys? ›

Pick those that do not contain dried fruit, nuts or chocolate. Good options include porridge, cornflakes, Rice Krispies, Weetabix, shredded wheat, Special K and Cheerios. Potatoes. Have these only occasionally and make sure that they are boiled in plenty of water, which is then thrown away.

Is hair dye bad for your kidneys? ›

Modern hair dyes contain paraphenylenediamine and a host of other chemicals that can cause rhabdomyolysis, laryngeal edema, acute kidney injury, severe metabolic acidosis, and acute renal failure. Intervention at the right time has been shown to improve the outcome.

What kind of kidney injury does contrast cause? ›

Contrast-induced acute kidney injury is the third most common cause for acute kidney injury (AKI) in hospitalized patients. It is usually mild and reversible, but in some patients, it can cause irreversible kidney injury requiring renal replacement therapy.

How do you flush contrast dye out of your body? ›

When the CT scan is over, you can resume normal activities. If you had intravenous contrast, you should drink at least eight glasses of water throughout the day to help flush the contrast out of your body. Your doctor will receive the results within 48 hours.

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