Large doses of iodinated contrast media (CM) are used for percutaneous cardiac interventions and are generally very well tolerated, but they can cause acute kidney injury (AKI). This review discusses the following topics:

• Classes of CM

• CM-induced acute kidney injury diagnostics: the problem with serum creatinine concentration

• CM-induced acute kidney injury: outline of pathophysiology

• Pathophysiological impact of cytotoxic CM properties and vasoconstriction

• Pathophysiological impact of osmolar and viscous CM properties

• Predicting risk of CM-induced acute kidney injury

• CM-induced acute kidney injury prevention: focus on hydration and dose reduction