Acute renal failure following intravenous use of radiographic contrast dyes in patients with diabetes mellitus.

Acute renal failure following roentgenologic procedures employing intravenous administration of contrast media was observed in seven diabetic patients over an 18-month period. All had long-standing diabetes mellitus complicated by retinopathy and cardiovascular disease; six had mild impairment in renal function before x-ray studies. The renal failure occurred within 48 hours of the procedure and was of the oliguric type in six of the patients. Renal function returned toward the prestudy levels within four weeks. None of the patients required dialysis. Combined analysis of our data and those of 31 cases reported in the literature suggest that certain factors in diabetic patients make them prone to develop dye-induced acute renal failure: These include old age; long duration of diabetes; preëxisting impaired renal function; the presence of diabetic complications such as retinopathy, neuropathy, and cardiovascular disease; and dehydration. All diabetic patients should be monitored closely after a radio-contrast study to detect the development of acute renal failure so that appropriate management can be instituted early in the course of the disease.