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Contrast AKI Natural History — ESENeph MCQ

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EasyAcute Kidney InjuryContrast AKI Natural HistoryESENeph

A 55-year-old woman develops contrast-associated AKI after coronary angiography. Her creatinine rises from 130 to 210 umol/L at 48 hours. It peaks at 72 hours (240 umol/L) then gradually falls. She remains non-oliguric. What is the expected natural history?

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Correct answer: A — Creatinine typically peaks at 3-5 days and returns to baseline within 7-14 days

Contrast-associated AKI typically follows a characteristic pattern: creatinine rises within 24-48 hours of contrast exposure, peaks at 3-5 days, and returns to baseline within 7-14 days in most cases. Risk factors include pre-existing CKD, diabetes, high contrast volume, and dehydration. The vast majority of cases resolve spontaneously. Persistent AKI should prompt investigation for other causes. Dialysis is rarely required.

Reference: KDIGO 2012 – AKI Guideline; Mehran et al 2019 – Contrast AKI Review