Which patient population is at the highest risk for contrast-induced nephropathy?

Patients with diabetes and pre-existing renal impairment are indeed at the highest risk for developing contrast-induced nephropathy (CIN). This is largely due to the fact that both diabetes and existing kidney dysfunction can compromise the kidneys' ability to filter blood and eliminate waste. Diabetes can lead to changes in kidney structure and function over time, diminishing the kidneys’ filtration capability. When these patients are exposed to contrast agents, which can be nephrotoxic, it can induce further damage to already compromised renal function, making them particularly susceptible to CIN.

Additionally, those with pre-existing renal impairment are often already under stress, and the additional insult from contrast media can exacerbate their condition, leading to impaired renal function. Managing the risks associated with contrast media in this patient population often requires careful hydration strategies and possibly alternative imaging methods when feasible to ensure patient safety and kidney health.