APPROACH TO THE RELATIONSHIP BETWEEN CONTRAST USE AND GLOMERULOPATHY

Abstract

Introduction: The relationship between the use of contrast in imaging exams and glomerulopathies has emerged as a significant concern in clinical practice, since the administration of contrast agents, especially those based on iodine, can trigger or aggravate renal damage. Glomerulopathies, which encompass a variety of conditions affecting the glomeruli, are characterized by inflammation and damage to the kidneys, and can lead to renal failure. Understanding the mechanisms by which contrast agents influence renal function is crucial to optimize patient safety and develop appropriate guidelines for the use of these diagnostic resources. Objective: To analyze the association between the use of contrast in imaging exams and the development or aggravation of glomerulopathies, seeking to identify patterns and guidelines that can assist in clinical practice. Methodology: The research was conducted following the PRISMA checklist, covering articles published in the last ten years, extracted from the PubMed, Scielo and Web of Science databases. Five descriptors were used: "contrast use", "glomerulopathies", "renal failure", "nephritis", and "adverse effects". Inclusion criteria considered studies that evaluated the relationship between contrast use and renal function, randomized clinical trials, and peer-reviewed articles. Exclusion criteria included studies with pediatric samples, publications that did not present empirical data, and research focused on other renal pathologies. Results: The results showed that exposure to contrast agents, especially in patients with impaired renal function, was frequently associated with an increased incidence of acute kidney injury. In addition, several studies indicated that the risk of contrast-induced nephropathy is increased in individuals with a history of diabetes mellitus and hypertension. Current guidelines emphasize the need for careful evaluation before administration of contrast in vulnerable populations. Conclusion: The systematic review showed that the use of contrast in imaging exams has significant implications for renal health, especially in patients predisposed to glomerulopathies. These findings reinforce the importance of a cautious and individualized approach when considering examinations involving contrast agents, aiming to minimize risks and protect renal function.