Consensus Report from Oncology Advisory Board Meeting

Contrast-induced acute kidney injury (CI-AKI) occurs in up to 30% cancer patients who receive iodinated contrast media (CM) for diagnostic, assessment, and management purposes. It is generally considered to be the third most common cause of hospital-acquired AKI. Accurate assessment of the incidence of CI-AKI is, however, obscured using different definitions and diagnostic criteria, the different populations studied and the prophylactic measures put in place. A deeper understanding of the mechanisms that underlie CI-AKI is required to enable reliable risk assessment for individual patients, as their medical histories will determine the specific pathways by which contrast media administration might lead to kidney damage. Here, we highlight the current definition of CI-AKI, as recommended by the International guidelines, common triggers and risk factors that prompt the development of CI-AKI in cancer patients, and optimal use of CM in cancer patients. We also discuss effective preventive measures, such as adequate hydration prior to CM administration, appropriate selection of CM, and avoidance of concomitant use of nephrotoxic agents. Understanding of how CI-AKI arises in different patient groups could enable a marked reduction in incidence and improved outcomes. The ultimate goal is to shape CI-AKI prevention strategies for individual patients. This compendium compiles the consensus report from India on Strategies for Prevention &Management of CI-AKI and the role of contrast in oncology CT setting. A panel of eminent nephrologists, radiologists, and oncologists were speakers during this meeting. Preface