Contrast Dyes and Kidney Damage

When Mom and I interviewed dialysis patients for our KidneySteps book, we were surprised at the number who told us they ended up on dialysis after receiving dye for a CT scan.  As a nurse, I also see patients who believe their kidneys were damaged by contrast dyes given during lab imaging tests.  These people aren’t imagining the damage.  Contrast agents, commonly used for coronary  procedures, are known to be toxic to kidneys.  The  kidney damage they cause is called contrast-induced nephrology (“CIN”).

People who already suffer reduced kidney function are particularly susceptible to CIN.  Those in stage 3 or 4 of kidney disease have the greatest risk.  Other risk factors for developing CIN include being diabetic, dehydrated, over age 70, having congestive heart failure, or using NSAIDs (aspirin and other pain relievers) at the time of the test.

You have CIN from contrast dye if your serum creatinine (kidney patients know what this is) increases by 25% from baseline (e.g. creatinine increases from 2 mg/dL to 2.5 mg/dL) within 2 to 3 days after receiving the dye.

CIN is usually temporary, with kidney function returning to normal within a couple of weeks.  However, just developing CIN is a hazard.  It is associated with a significantly higher risk of death while in the hospital and within a year thereafter.  In those with kidney disease, CIN can be permanent and can propel someone into end stage and dialysis.

Unfortunately, many physicians ordering CT scans with contrast dye are not fully informed about the CIN risk.  If the patient is diabetic and/or has a creatinine level greater than 2 or 3, CIN can result up to 50% of the time, studies indicate, which sharply increases risk of death and permanent kidney damage and dialysis.

What to do:  If your doctor orders a test that includes contrast dye, express your concern about your diabetes or kidney function.  Ask about an alternative (such as an MRI), and see if the test is urgent.  I have told my mother, the recipient of my kidney, to avoid contrast imaging.  Transplantation does not cure kidney disease, and avoiding contrast dyes where at all possible is a reasonable precaution.

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51 Responses to Contrast Dyes and Kidney Damage

  1. norman west says:

    I told the dr my creatine levels were 2.4 and he injected me with dye anyway…..it made me feel warm for a few seconds all the way from my waist to my knees………when in the hospital 5 yrs ago I had a 2.1 creatine and they shot me with dye but I felt no heat
    or warning of heat.

    • Vicki says:

      Certain dyes do cause the feeling of heat radiating through the body. The “heat” sensation is insignificant and passes. It is the contrast dye itself that can harm kidney function in people with already compromised function.

  2. Shannon says:

    How common is it for someone with normal kidney function to get CIN? I had a ab/pelvic ct done about 3 days ago and I know I was dehydrated before the test. The next night after the scan I started getting kidney pain and it hasn’t gone away since then which has been 2 days. Do you think this could have damaged me since I was healthy beforehand?

    • Vicki says:

      Shannon, thank you for visiting us. Your pain could be something other then kidney pain. Many people with very poor kidney function never experience pain. Please call your doctor to see what other reasons might lead to your pain. If you really want assurance that your kidney function remains good, ask for both a blood test to determine your GFR and an albuminuria test for protein in your urine.

    • Chris c says:

      Shannon, did you find a remedy? I’m going through the same pain issue.

    • Magi says:

      Shannon, I had a PET scan & Pelvic sonogram 3 weeks ago & have developed kidney pain this week. I went to the Dr today & she is treating it like a kidney infection. Not sure what to do.

  3. Angie Jeffreys says:

    My Mother had about fifteen (15) contrast dye test between
    1994-2008. She had triple bypass surgery in ’94 and several
    cardiac “events” since. For the past several years she has dealt
    with kidney problems and has been told dialysis is in the near
    future. The fistula clogged before she healed from the surgery
    and that was just over 3 years ago. Now, congestive heart
    failure, kidney disease and lingering effects from strokes are
    Taking their toll on her 72 year old body. I don’t understand
    kidney disease. I think she may have some atypical symptoms.
    I live in a different state and can’t make it to many of
    her Dr appt. I’m afraid she’s near death and I’m trying to
    Figure out how much time I have left with her. Is there
    Anything you can tell me? I don’t even know what kinds of
    Questions to ask the Dr. Her creatinine levels fluctuate a lot.
    Any advice or info would be welcome.

    • Vicki says:

      Angie, your mother’s health sounds poor. Dialysis my extend her life but is difficult. Cardiovascular events are the primary and likely cause of death for people with kidney disease and for people on dialysis. Perhaps, you may want to arrange a meeting (appointment) for your mother with her nephrologist (kidney doctor) at a time you can attend. (She should be seeing a nephrologist and not just her family doctor.) The nephrologist can give you a good idea of your mother’s kidney status and likelihood of success on dialysis.

      Good luck to both of you, and thank you for visiting this site. If you search through different topics on the site, you will learn much about dialysis and kidney disease itself.

  4. TERRI ROMERO says:

    On 05/28/2013 I had an MRI with contrast dye done on me because of bad pain in my right shoulder( which I later found out was a Rotary Cuff tear)as soon as the MRI TEST was finished I felt very dizzy and could not walk without help, I was also talking a little slurry in my speech as if I were drunk and felt very doped-up.I was told that this would soon pass, that I should just drink a lot of water to flush out the dye. Well I went home and did exactly that, but 6 days later I was STILL DIZZY! It got WORSE on 6/02/2013 and I got scared and went to the Emergency Room. I had a lot of test done on me and was told that I WAS JUST HAVEING VERTIGO. I was also feeling very weak and was told that I also had a urinary tract infection and the E.R. Doctor gave me a prescription for Cipro and also MECLIZINE TABLETS for the dizziness. Is it possible that I could have gotten KIDNEY damage or even made my kidneys worse because of the contrast dye. I still don’t feel well but the dizziness has subsided.MAY I GET AN OPINION FROM SOMEONE.

  5. Vicki says:

    Terri,

    Thank you for leaving your comment. Your symptoms are not normal post-MRI reactions. If the contrast dye did harm your kidney function, you will want to know immediately. Please have blood and urine tests (very simple process) to determine that current status of your kidney function. Thank you.

  6. TERRI ROMERO says:

    Thankyou Vicki. From TERRI 06/06/2013.

  7. Annette says:

    I was so happy to find your site. My 74-year old mother is currently in the hospital. She is a diabetic (due to a Whipple procedure from caner in ’90). She struggles with high BP, terrible shortness of breath, and lately weight loss due to la k of appetite). She has been hospitalized three times this year due to fluid in lungs. Her creatine level is 2.7, which I understand from the nephrologist means about 75% of her kidney function is gone.

    We just received the results of her VQ scan from yesterday which shows a potential clot in the lung. I believe the VQ suggests about a 50% chance of having a clot. I understand that doing a CT scan to confirm or dispel the possibility of a clot would like damage her kidneys more. On the flip side, I also understand that placing her on blood thinners if she doesn’t have a clot could cause potentially dangerous side effects.

    I would be so apprecistive if you have any strong recommendation as to whether to proceed with the CT scan (and risk further kidney damage) or start on blood thinners and assume this is a clot.

    Kindest Regards,
    Annette

    • Vicki says:

      Annette, thank you for contacting us. You and your mother must find all of this difficult and frightening. She is fortunate that she has you to seek information for her.

      Please have a candid conversation with her medical team, which should include a nephrologist. There are options to a CT scan that may provide the information the doctors seek but are safer for your mother’s kidneys. Also, new approaches exist for flushing the system of the contrast dye or diluting it, if the CT scan is the only option. For example, some patients do much better if given an IV diluting solution for several hours before the scan and then following the scan. Also, there are several dyes, some safer for kidneys than others. Perhaps, you can explore all these options with the doctor. Good luck to your mother.

  8. Annette says:

    Many thanks for any advise or info you might be able to share.

  9. Vicki says:

    Annette, see above. Thank you.

  10. Annette says:

    Vicki, I can’t thank you enough for your response. That was so helpful and informative. Thanks again for your kindness and quick response. What a blessing you obviously are to so many people seeking information.

    Thanks again,
    Annette

  11. Vicki says:

    Annette, you are most welcome. Please let me know how your mother is in a few months. Thank you.

  12. Gisele Anderson says:

    Hello,

    I am so thankful I have found this site! My father, age 92, recently had a cystoscopy. He has had them annually for quite some now, as he has had low grade bladder cancer since 1985. It has been kept under control with occasional bladder restricted chemo treatments and burning off the tumors during a cystoscopy. Last year,the urologist noted several small tumors in his left ureter which he burned off. During this last surgery, he investigated further up the ureter and into the kidney. He noted that the uppermost calyces was blocked, and enlarged. Everything else looked normal. He order a CT scan, however, he mentioned that my father’s latest creatinine level was 1.7 prior to the surgery, He ran another blood test last week, and his creatinine level was at 1.4. My father had been on Lisinopril for over a year, and we just took him off it last week in favor of another blood pressure medication called Losarpan. His MD told him that his creatinine levels were elevated because of the Lisinopril and that he was getting a ‘false reading’. I am very concerned about the risks associated with a CT scan at his age, and with the elevated creatinine levels. He is not a candidate for an MRI because he has a pacemaker. Any thoughts on how best to proceed? We are meeting with his urologist again tomorrow at 4 PM. Thank you so much.

  13. Vicki says:

    Thank you, Gisele, for visiting our site and for your questions. A creatinine of 1.4 is rather impressive for a 92-year old. Your concern about contrast dye is merited, though. If no other test option is available, perhaps you can discuss with the doctor whether the test is even necessary, given your father’s age. If there is renal cancer, some studies indicate the tumors can take years to cause serious problems.

    Also, discuss different dye types. Some are less harmful to kidneys. Also ask about IV infusions prior to the test and then after the test to help neutralize the dye. This approach has been used recently.

    Good luck.

  14. Gisele Anderson says:

    Thank you so much. We had a great meeting with my Dad’s urologist, and have decided to wait another 3 weeks to see if his creatinine levels drop now that he is no longer on the Lisinopril. We will also ask them to use the contrast “Isovue, if we do the CT scan which seems to fare better. I really appreciate your feedback. God Bless You!

  15. Vicki says:

    I’m pleased your meeting went well. I look forward to hearing more from you.

  16. Teresa Altman says:

    I have a six year old with Spina Bifida as result she has neurogenic bladder. We adopted her and she has been with us for 8 months. In late December routine blood work showed a creatinine level of .27
    On June 11 she had an IVP done so she received contrast for that. Yesterday we had to go back and have a CT of her abdomen and pelvis with contrast. Before doing the test they tested her blood and her creatinine was 2. They said it was fine, but after getting home it just didn’t sound right to me. Should these levels come down on their own? Other facts about her she is on an antibiotic for a UTI. Didn’t know if just having a UTI could increase creatinine levels.

    • Vicki says:

      Teresa,
      Thank you for visiting our web site. We agree with you that a creatinine of 2 is too high. Please talk to your doctor about this, and have it checked again.

  17. Ram says:

    Hi Vicki,

    My mom had an angiogram done 2 months back. Her Creatinine was 2.5mg/dl before the procedure and was 2.8mg/dl after 72 hours and in a week came down to 2.6mg/dl. 2 weeks later, it dropped to 2.0mg/dl.

    But after 2 months now, it is rising and is at 5.4mg/dl
    She has a UTI and takes antibiotic for that. She was recently put on insulin for her diabetes
    Would CIN show its impact after 2 or 3 months and raise Cr levels? or could it be the UTI? She is 10 days into the antibiotic course.

    Please advice

    Thanks,
    Ram

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  21. Tina says:

    Thank you for posting this. I was hospitalized 6 years ago and had 4-5 CT’s with contrast dye during that time. I also kidney stones at that time. Ever since that hospital stay I have had chronic kidney issues even after I had the stones blasted. I get dehydrated very easily and have had multiple kidney infections. I also have issues with swelling. I also developed food allergies after that. I had a reaction to the dye each time in the hospital and I’ve always known all of this is related to the contrast dye but cannot find a doctor that agrees.

  22. Rhonda says:

    My 76 year old father had abdominal aneurysm surgery in July 2015, and they also put stents in his legs where some arteries were clogged. In October, he had a penile growth removed that showed evidence of cancer, so the Urologist did a CT scan to make sure the cancer had not gone into his body. That night, he was in the hospital in severe pain ( we don’t know where the pain came from ) – but his kidneys had shut down from the contrast dye. The nephrologist was pretty certain his kidney function would return, but it has been three weeks and it has not yet. His stay in the hospital was awful,- he suffered a lot of complications – shortness of breath, internal bleeding that landed him in ICU, etc., and he is now on dialysis- hopefully not forever. He is getting out of the hospital today. The Urologist came to the hospital in July to see him after his abdominal surgery in July – He knew all about it. My question is, should he have taken the risk with the contrast dye? None of us knew anything about contrast dye- and after reading about the risks, we’re pretty upset. He’s supposed to go back December 1 for a little more outpatient surgery to make sure all of the growth is gone. Should he even go back to that Doctor? We’re disappointed they neither he nor any of his office staff have called- the Nephrologist said he was going to talk to him. My mother and father said that no one every verbally discussed any risks with them. I’m sure they signed some papers, but everyone has to do that.

  23. M.kesh says:

    It maybe consider malpractice you should contact a lawyer.

  24. Vicki says:

    Rhonda,

    Your father’s situation is most unfortunate. I have personally found that many doctors think nothing about ordering contrast dye, even with other options exist. For example, an MRI without dye often reveals what the doctor is after. Also, several studies indicate that precautions can be taken, such as giving IV fluids, that can reduce the risks of dye. There are even several types of dyes that can be used to reduce odds of damage.

    It is common that patients don’t know the risks involved to the kidneys, but doctors should.

    • Rhonda says:

      I had a long talk with my father’s kidney doctor. He said that a team had reviewed his case and could not give a good explanation of why his shut down.. that his kidneys tests before the dye scan showed that everything was fine. It has been three months now – they have not come back, but we are still hopeful.

  25. Rhonda says:

    Does anyone know what the signs are that kidneys may be trying to heal? I can’t seem to find anything about that. What should you be looking for, or is it all blood tests?

  26. Vicki says:

    A blood test to determine the “estimated glomerular filtration rate” (GFR) is the only sure way. It’s simple. I have it done every two months.

  27. minnu says:

    Hello ,
    my father is 56 yrs of age his creatnine is 8.4 just tell me how to cure him .he has sugar and bp from 15 yrs is kidney transplant better or dialysis

    • Vicki says:

      Minnu,
      Thank you for your comment, and we are sorry about your father. He may wish to ask his nephrologist (yes, he should have one if he doesn’t already) to tell him his GFR. The GFR will indicate your father’s kidney disease stage. Different labs use varying measures for creatinine, but in many a reading of 8.4 suggests dialysis. Your father’s high blood pressure and sugar levels will continue to damage his kidneys.

      No cure exists for kidney disease, but it can be slowed or stopped in its early stages by good lifestyle habits, studies say. Hands down, transplant is so much better than dialysis, but a matching kidney is not always available, and the wait on a transplant list can be years. He should try to find a relative or friend willing to donate. Good luck to your father with his situation. Having kidney disease is distressing.

  28. David Kane says:

    Your story is precisely what my wife is going through as we speak. She went into the hospital with perfect kidneys. She was running a temp. and they ‘immediately’ injected her with the deadly dye gave her a cat scan. Never once, noticing she was diabetic and we both take Nsaids 24/7 for arthritis and other pain….again, never asked. WHY can’t they be held responsible? Then they sent her home with 2 vials of pills after only 2 days at Cooper Hosp. and the fever returned with a vengeance. This time we had the ambulance take her to a better hospital, Virtua in Voorhees. Brand new and gorgeous hosp. Again, first thing they do….inject her again and into the Cat Scan. After about a week of being in there, on Dec. 27th, the Dr. tells me they are transferring her to yet another hosp. because they don’t have the equipment for Dialysis. Now, I am in shock. Although your article says that most get better after two weeks, this Dr. “DOOM” SAYS that won’t be the case and she will probably need it for life…..just like that. Tomorrow they put in some type of ‘port’ and run it along her collarbone and give her the first treatment. I’m so scared and although they are keeping my wife doped up with deladdid; I see the fear and sadness in her eyes as she keeps repeating “somebody screwed me up. I was fine before I came in here.” What can I do as her husband. Should I contact our lawyer, although that won’t bring my baby back the way she went in.

    • Vicki says:

      David, What a distressing time for you and your wife. This unfortunate event is not uncommon and should not have occurred. Ways exist to reduce the possibility of kidney damage from contrast dyes, such as the use of hydration to dilute the dye during the test, as well as before and after. Different types of dyes exist, some more damaging then others. Also, a non-dye test with an MRI is often available and is just as effective in evaluating the medical problem.

      Certainly, the medical staff should have immediately determined the current kidney function status of your wife with a simple blood test before ever using contrast dye. Some hospitals routinely do this and then will not use the dye if kidney function is low.

      Since your wife has diabetes (the leading cause of kidney disease) and she takes NSAIDs often, it is likely her kidneys were already damaged when she first entered the hospital. Any doctor should have been alert to that before considering the use of contrast dye.

      Please contact a nephrologist immediately. This kidney specialist is in the best position to evaluate your wife’s condition. If you wish to contact a lawyer, please keep in mind that most states put a short time limit on bringing a malpractice suit. You will not want to delay long.

      Good luck to your wife in this most difficult time.

      • David Kane says:

        Thank you, Vicky for your kind words. She had her initial Dialysis treatment yesterday. It took a lot out of her. It was only 2 hours but
        she was very tired before they took her down. Sleep must be taken
        when you can get it in hospitals. I have asked many nurses etc. about why an alternative to a contrast dye wasn’t even considered. All they kept saying was “that gives US the clearest view”. What about an MRI and they said that wouldn’t work in her case. How about a CAT without
        the dye and she just looked at me. and said “you’re not moving me again are you?” So, although Penn has the very best Doctors, it seems all there is left to do is give her dialysis and pray her levels drop down on a daily basis.

  29. Chelsea says:

    I am a relatively healthy 24 year old. I have had problems with kidney stones in the past. About 3 weeks ago I started having pain underneath my ribcage and nausea. They gave me an ultrasound, and it was fine. Then they gave me a hida scan, which again came back fine. Well, today I had a ct with contrast. I had the burning sensation while it was being injected which I was told is normal and when it was over I was sent home. But now I am having pain in my kidneys. I am worried that it is another stone or some kind of reaction to the dye. I am not sure what to do. Any advice would be appreciated. Thanks in advance.

    • Vicki says:

      Chelsea,
      We strongly suggest that you see a nephrologist. We like the ones associated with teaching hospitals (hospitals associated with a medical school). A nephrologist can help you with your kidney stone issues as well as help you safeguard your kidney function.
      Good luck!

  30. Rod says:

    Hi and thanks for the site. I had a horrendous reaction to improperly prescribed meds that pretty much destroyed my health, including my kidneys. I immediately showed signs of proteinuria. In your opinion, is it dangerous to receive any future contrasting dyes that may be recommended? Have you ever heard of anything that can reverse kidney proteinuria? Thanks for your generous time you have provided on your site…it is greatly appreciated! BTW, I do realize this is your opinion and not advice so feel free to answer as openly as you want.

    • Vicki says:

      Rod,
      Thank you for your comment, and we are very sorry about the unfortunate drug reaction you suffered. Kidneys are so important, and so many medical practitioners aren’t even aware that certain drugs they prescribe are life-threatening to kidney function.
      Yes, we have heard of kidney functioning returning in situations like the one you described. People who follow a very healthful diet — like a whole plant based diet–may see kidney function improvement. Most important, though, is that you confer with a good nephrologist.
      Good luck on your recovery.

  31. Aman says:

    Hi Vicki
    My mother (66 years old)suffered a heart stroke 3 days back. She is diabetic, hypertensive and also has thyroid. Her both knees were transplanted about 5 years ago.
    Her angiogram was done and it was found that 2 of her arteries were blocked. Doctor said that Angioplasty procedure will be performed. But her creatine level rose from 1.8 to 3.3 in last two days. Today this has come down to 2.9. I’m worried now that even if her creatine level comes to normal, how angioplasty will be performed as 3 times the amount of contrast dye is used in angioplasty than that of angiogram. Now if she has developed CIN after angiogram itself, what is the way for performing angioplasty?
    Seeking your comments.
    Aman (India)

    • Vicki says:

      Aman,
      Angioplasty involves contrast dye here in the U.S., too. It can be a damaging procedure for someone with already-damaged kidneys. Your mother’s doctors knew in advance that her kidneys were not functioning fully. Of course, angioplasty is often performed on an emergency basis, with the heart considered more important than the kidneys. We presume a nephrologist is involved, which is important. Doctors performing the heart procedures can take certain precautions before and after the contrast-dye administration to lessen the dye’s impact.
      Good luck to your mother. She is fortunate to have your involvement and care.

  32. c. segerstrom says:

    I just had contrast dye 9 days ago and I have had 3 days of pain and bloat and absolutely no feeling in my bladder either to eliminate or to urinate at all at times. I went to the doctor twice and they are not sure what is wrong. They said uti/constipation and I suspected the dye because of the numerous symptoms I felt afterwards???
    I had sharp pains before antibiotics on the right side kidney location with incredible bloat. I have had no issue of any health problems but was having a physical but had blood in the urine and they did this test.

    • Vicki says:

      Thank you for your comment C. Segerstrom. Jennifer (the nurse) and I spoke about your issue. The safe thing to do is to see a nephrologist, if you have not already. As a kidney specialist, a nephrologist can better determine if you have an issue. Good luck.

  33. Dawn says:

    We are trying to help my mom make a decision about having an angiogram and do not know what to do. She has stage 4 kidney disease, with a current GFR of 19. Her creatinine is above 2 and under 3. The doctors believe she has a blockage in an renal vein to her kidneys because when she goes on lisinopril her kidney function drops and when she comes off it goes up. The lisinopril controls her blood pressure but lowers her kidney function. She also has one kidney that is small and probably not functioning. She is very small and frail and 83, Diet, and blood pressure meds do not control her blood pressure very well. It now hangs around 170 and 180. After talking with a the doctor that does the angiogram it appears too risky to me. Besides the risk of the dye, there is the risk of some plaque breaking off and causing some blockage to the kidney if a stent is placed. I am thinking she might do better just trying to keep the blood pressure down and when they feel it is time to go on dialysis, do that. They said if everything goes well, this procedure could reduce her blood pressure, and hold off dialysis. I am a bit afraid, this might make it worse. I guess it is a 50-50 chance. Don’t know what is best for her. Any comments?

    • Vicki says:

      Dawn,

      If you have not already, please discuss this issue with your mother’s nephrologist. The downsides of the procedure are significant, primarily because of the contrast dye coupled with your mother’s poor kidney function. Also, other testing options exist. For example, my doctor examined my renal arteries for blockage using an ultrasound without dye. My sister, who has kidney disease and is in early stage 4, is having a radio nuclear medical scan that does not involve dye to determine if her renal arteries are blocked. Her Boston University nephrologist said that because her kidney function is at about 35% (higher than your mother’s), she must avoid contrast dye. However, please discuss this with a good nephrologist. Also, your mother’s elderly age should play in the consideration.

      Good luck to you both.

  34. Kristina says:

    Hi. Which contrast dyes are better? I have an apt. with a kidney specialist in four weeks, but my cat scan is scheduled today. (With contrast) I want to be able to ask for a lighter or better dye so that it’s not so hard on my kidneys. Thanks so much.