Journal of Invasive Cardiology

Contrast-induced nephropathy (CIN) is a common problem after cardiac catheterization and percutaneous coronary intervention (PCI), and is associated with substantial morbidity and mortality.^1–3 The etiology of CIN has not been clearly delineated. Renal ischemia is the most likely mechanism, although several other mechanisms have been suggested to contribute to this problem.⁴ Preprocedural hydration, N-acetylcysteine and bicarbonate infusion have been used to reduce the incidence of CIN after contrast-related procedures.^5–8 The volume of contrast used during a procedure is also a factor that may correlate with the incidence of CIN.^3,9 Importantly, contrast volume is one of the few procedural variables that can be modified during a coronary catheterization procedure or PCI, and thus, potentially reduce the incidence of CIN. Automated contrast delivery systems are now commercially available and appear to allow lower procedural contrast volume without compromising image quality or safety.^10–12 Whether the use of an automated contrast injection system, by reducing contrast volume, can modify the incidence of CIN is uncertain. Accordingly, we assessed the incidence of CIN after cardiac catheterization and PCI using traditional hand injection techniques, and compared this to the incidence of CIN using an automated contrast delivery system.