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د. أنس اليوسف
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د. أنس اليوسف
@anasalyousef
استشاري أمراض باطنية وأمراض كلى وارتفاع ضغط الدم (البورد الكندي) مستشفى السلام الدولي 1830003
الكويتKuwait Katılım Nisan 2011
281 Takip Edilen6K Takipçiler
د. أنس اليوسف retweetledi

🩻Contrast-induced AKI:
one of the biggest myths still shaping clinical decisions
For decades we were taught:
👉 “Contrast damages the kidneys”
👉 “Avoid CT with contrast in CKD”
👉 “Hydrate, protect, delay imaging if needed”
But what if… most of this is wrong?🤔
->The uncomfortable reality
Modern evidence shows:
👉 Low-osmolar contrast rarely causes true nephrotoxicity
👉 Even in CKD, AKI, and ICU patients
👉 The risk is often overestimated—or nonexistent
So where did the fear come from?
📍 1950s high-osmolar contrast (actually toxic)
📍 Poorly controlled observational studies
📍 “Creatinine rise = contrast injury” assumption
👉 Correlation became causation
👉 And the dogma stayed
⚠️What recent data tells us
✔ No difference in AKI rates with vs without contrast
✔ No benefit from bicarbonate, NAC, or aggressive hydration
✔ Even ICU and AKI patients show no worsening outcomes
->Translation to real life
👉 The patient was going to develop AKI anyway...Not because of contrast!!
->The real problem: “Renalism”
👉 Avoiding necessary imaging
👉 Delaying diagnosis
👉 Choosing inferior tests
And that leads to:
❌ Missed PE
❌ Delayed sepsis source control
❌ Worse outcomes
->Clinical mindset shift
Instead of asking:
👉 “Will contrast harm the kidneys?”
We should ask:
👉 “Will NOT doing the scan harm the patient?”
->Who still deserves caution?
✔ eGFR <30
✔ Severe hemodynamic instability
✔ Multiple nephrotoxins
Even then:
👉 Optimize volume
👉 Minimize dose
👉 Don’t delay critical imaging
🤓Bottom line
✔ Contrast nephrotoxicity exists… but is rare
✔ The fear is bigger than the risk
✔ The harm of NOT imaging is often greater
In critical care
👉 We don’t treat creatinine
👉 We treat patients
And sometimes…
👉 The most dangerous thing is NOT the contrast
👉 It’s hesitation.
📃Reference
Florens N, Demiselle J.
Kidney360 7: 445–449, 2026. doi: doi.org/10.34067/KID.0…

English
د. أنس اليوسف retweetledi

🇸🇦🇰🇼❤️🇸🇦🇰🇼
يا كُويْتَ العزِّ يا من أثبتَتْ
أن هذي الأرض تأبى تُستباحْ
يا كويت الفخرِ بالشعبِ الأبي
كلُّ من عاداك تذروه الرّياحْ
جِئْتُ مِنْ أرْضٍ صدوقٌ ودُّها
مَنْ وَفَتْ في السِّلْمِ أوْ وَقْتِ السِّلاحْ
جئتُ من سلمان باني مجدنا
من ذرى الملهوف من مبري الجراح
من أبي سلمان أأتي ناقلاً
صدقَ صافي الود يا دار الصباح
🇸🇦🇰🇼🇸🇦🇰🇼🇸🇦🇰🇼
حفظ الله السعودية والكويت وأدام المحبة بيننا وآمننا في اوطاننا وحفظ لنا أمننا واستقرارنا في بلدينا وفي كافة دول الخليج العربي
القبس@alqabas
الكويت والسعودية.. إخوة إلى الأبد
العربية
د. أنس اليوسف retweetledi
د. أنس اليوسف retweetledi

@lawyeralbarrak عظم الله أجركم عسى الله يغفر لها ويرحمها برحمته
العربية
د. أنس اليوسف retweetledi

😢 🇲🇩 The Minister of Health of Moldova almost cried while explaining where he got his €99,000 car
With a trembling voice, Emil Ceban explained how he had always driven used cars — and that he ordered this one long before becoming a deputy and minister.
Ceban also recalled his difficult past: working as a janitor after the eighth grade, living with his whole family in one room, and even the death of a child. But the tears came not from these memories, but when the conversation turned to the €99,000 car.
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