The use of radio-opaque contrast media (ROCM) has been an essential portion of imaging since the first primitive agent was introduced in 1929. The current agents are utilized in an ever increasing frequency secondary to the recent introduction of multidetector computerized tomographic units (MDCT). These agents are minimally injurious to most patients. However there are potential hazards. One adverse reaction is nephrotoxicity. This complication is listed as the second most common cause of acute renal failure (ARF) in hospitalized patients.

The current investigation is to evaluate the detection of acute renal failure (ARF) based upon glomerular filtration rate (GFR). The GFR is more appropriate in the evaluation of renal status than serum creatinine determination. This observation is based upon the need to reduce the GFR to <60 ml/min/1.73 m2 (normal 120 ml/min/1.73 m2) before an alteration of the serum creatinine is seen. The change in creatinine level may not be identified until 48 hours after the injection of the ROCM.

The IRB approved investigation is to determine the renal status shortly after the contrast media injection. The evaluation of GFR uses the iodine of the ROCM as the marker. Initially, the base line GFR is established utilizing 15 ml of the ROCM to be used in the diagnostic imaging study. A blood sample is obtained for analysis. The injection of the ROCM, appropriate for the study, is performed. Another blood sample is obtained for analysis. It is appreciated that the impact upon renal function is rapid as is seen in some patients with a persistent nephrogram (prolonged opacification of the renal parenchyma and no opacification of the pelvicalyceal system). The initial investigation is the patient cohort with no predisposing renal function factors (e.g., diabetes mellitus, poor cardiac function, elevated serum creatinine, dehydration, etc.). Following studies will look at the potential protective procedures such as anti-oxidants in the normal and ''at risk'' patients.