LAUSR

Contrast ‐ associated acute kidney injury (CA ‐ AKI) is rather common after percutaneous coronary intervention with a significant impact on both short and long term mortality and morbidity. 1,2 Several pathophysiological mechanisms have been postulated to explain this association of renal injury after administration of contrast media agents including patient and procedural factors. Prevention is key and there are standardized, validated contemporary risk score modeling to predict the risk of CIN to identify the high risk cohort and help guide management. 3 It is well ‐ established that low ‐ osmolality and iso ‐ osmolality contrast agents as associated with lower risk of kidney injury compared to high ‐ osmolality agents. 2 However, the benefit of iso ‐ osmolar contrast agents in decreasing acute kidney injury compared to low ‐ osmolar agents is very controversial and there are conflicting results from different studies. 4 iso ‐ authors 2009 incidence of adverse initiation