Risk factors for contrast nephropathy Risk factors for nephrotoxicity are the following: Older age Preexisting chronic kidney disease Diabetes mellitus Heart failure Multiple myeloma High doses (eg, > 100 mL) of a hyperosmolar contrast agent (eg, during percutaneous coronary interventions) Factors that reduce renal perfusion, such as volume depletion or the concurrent use of nonsteroidal anti-inflammatory drugs (NSAIDs), diuretics, or angiotensin-converting enzyme (ACE) inhibitors Concurrent use of nephrotoxic drugs (eg, aminoglycosides) Liver failure Diagnosis of Contrast Nephropathy Serum creatinine measurement Diagnosis is based on a progressive rise in serum creatinine 24 to 48 hours after a contrast study.