Salah Ayad Mohamed Nawaf, Waleed Abdullah Alkharji Faisal, Fuad Ghareeb Majd, Aljabr Aljoharah
College of Medicine, AlMaarefa University, 71666, Riyadh, 11597, Saudi Arabia.
Altakassusi Alliance Medical, Riyadh, Saudi Arabia.
Pediatr Radiol. 2025 Nov;55(12):2518-2530. doi: 10.1007/s00247-025-06380-6. Epub 2025 Aug 26.
Contrast-induced acute kidney injury is a significant concern in pediatric populations following the administration of intravenous iodinated contrast media. This narrative review aims to systematically evaluate the incidence, risk factors, and diagnostic criteria associated with contrast-induced acute kidney injury in children, addressing the variability in reported rates and the implications for clinical practice. The rationale for this review stems from the need to clarify the relationship between iodinated contrast media exposure and acute kidney injury, particularly in high-risk pediatric patients, as existing literature presents inconsistent findings. A comprehensive literature search was conducted using PubMed, Scientific Direct, and Google Scholar databases, focusing on studies published between 2020 and 2025 that addressed contrast-induced acute kidney injury in children. The review identified key messages, including that contrast-induced acute kidney injury incidence ranges from 1.4-35%, influenced by factors such as chronic kidney disease, estimated glomerular filtration rates, age, and gender. The findings emphasize the need for standardized diagnostic criteria and protocols to improve the assessment and management of contrast-induced acute kidney injury in children. Additionally, there is a gap in robust randomized controlled trials, highlighting the necessity for future multicenter studies to explore novel biomarkers for early detection and effective preventive strategies. This review advocates for a balanced approach to using iodinated contrast media in pediatric patients while aiming to prevent unnecessary exclusions from vital diagnostic procedures.
对比剂诱导的急性肾损伤是儿科人群在静脉注射碘化造影剂后一个重要的关注点。本叙述性综述旨在系统评估儿童对比剂诱导的急性肾损伤的发病率、危险因素和诊断标准，解决报告率的变异性及其对临床实践的影响。进行本综述的基本原理源于需要阐明碘化造影剂暴露与急性肾损伤之间的关系，特别是在高危儿科患者中，因为现有文献的研究结果并不一致。使用PubMed、科学Direct和谷歌学术数据库进行了全面的文献检索，重点关注2020年至2025年期间发表的关于儿童对比剂诱导的急性肾损伤的研究。该综述确定了关键信息，包括对比剂诱导的急性肾损伤发病率在1.4%-35%之间，受慢性肾病、估计肾小球滤过率、年龄和性别等因素影响。研究结果强调需要标准化的诊断标准和方案，以改善儿童对比剂诱导的急性肾损伤的评估和管理。此外，在强有力的随机对照试验方面存在差距，突出了未来多中心研究探索用于早期检测的新型生物标志物和有效预防策略的必要性。本综述主张在儿科患者中采用平衡的方法使用碘化造影剂，同时旨在防止因不必要的原因而无法接受重要的诊断程序。
