What patients are considered high risk patients for IV contrast for CIN?

This answer is very broad but here are some typical responses :

• The patient with a history of renal disease especially if the patient is a diabetic
• A patient on certain known nephrotoxic drugs such as aminoglycosides and amphotericin B
• Dehydrated patients regardless of the cause
• Patients with poor cardiac status including congestive heart failure
• Patients with multiple myeloma
• Patients with recent contrast injection of more than 100-120 ml in the preceding 24 hours (potential increased risk)

Recent articles question ehether iodinated contrast alone is really a risk factor for CIN. Many articles now question if not giving IV contrast when needed actually puts the patient at greater risk than giving it. Stayed tuned for further updates.

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"Intravenous contrast material administration was not associated with excess risk of AKI acute kidney injury , dialysis, or death, even among patients with comorbidities reported to predispose them to nephrotoxicity."

Intravenous contrast material exposure is not an independent risk factor for dialysis or mortality.
McDonald RJ et al.
Radiology. 2014 Dec;273(3):714-25

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"Within this cohort, the risks of AKI acute kidney injury ( OR odds ratio , 0.94; 95% confidence interval [ CI confidence interval ]: 0.83, 1.07; P = .38), emergent dialysis ( OR odds ratio , 0.96; 95% CI confidence interval : 0.54, 1.60; P = .89), and 30-day mortality (hazard ratio [ HR hazard ratio ], 0.97; 95% CI confidence interval : 0.87, 1.06; P = .45) were not significantly different between the contrast group and the noncontrast group. Although patients who developed AKI acute kidney injury had higher rates of dialysis and mortality, contrast material exposure was not an independent risk factor for either outcome for dialysis ( OR odds ratio , 0.89; 95% CI confidence interval : 0.40, 2.01; P = .78) or for mortality ( HR hazard ratio , 1.03; 95% CI confidence interval : 0.82, 1.32; P = .63), even among patients with compromised renal function or predisposing comorbidities."

Intravenous contrast material exposure is not an independent risk factor for dialysis or mortality.
McDonald RJ et al.
Radiology. 2014 Dec;273(3):714-25

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"Although patients who developed AKI acute kidney injury had higher rates of dialysis and mortality, contrast material exposure was not an independent risk factor for either outcome for dialysis ( OR odds ratio , 0.89; 95% CI confidence interval : 0.40, 2.01; P = .78) or for mortality ( HR hazard ratio , 1.03; 95% CI confidence interval : 0.82, 1.32; P = .63), even among patients with compromised renal function or predisposing comorbidities."

Intravenous contrast material exposure is not an independent risk factor for dialysis or mortality.
McDonald RJ et al.
Radiology. 2014 Dec;273(3):714-25