This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: None, Subject name: Medicine
[{'content': 'Which of the following indicates renal impairment in contrast induced nephropathy \nSelect and explain. \nA. Increase in serum creatinine, B. Decrease in serum bilirubin, C. Increase in serum bilirubin, D. Decrease in serum creatinine', 'role': 'user'}, {'content': "Answer: A \nExplanation: Contrast nephropathy leads to a rise in serum creatinine within 24-48 hours, peak within 3-5 days, and resolution within 5-7 days.\n'Contrast nephropathy leads to a rise in sent in creatinine within 24-48 hours, peak within 3-5 days, and resolution within 5-7 days. -\n\xa0Contrast Nephropathy lodinated contrast agents used for cardiovascular and CT imaging are a leading cause of AKI (Acute Kidney Injury).\nThe risk of AKI, or ‘contrast nephropathy,’ is negligible in those with normal renal function but increases markedly in the setting of chronic kidney disease, particularly diabetic nephropathy Q .\nThe most common clinical course of contrast nephropathy is characterized by a rise in SCr beginning 24- 48 hours following exposure, peaking within 3-5 days,\nand resolving within 1 week Q . More severe, dialysis-requiring AKI is uncommon except in the setting of significant preexisting chronic kidney disease,\noften in association with congestive heart failure or other coexisting causes for ischemiaassociated AKI. Patients with multiple myeloma and renal disease are particularly susceptible Q .\nLow fractional excretion of sodium and relatively benign urinary sediment without features of tubular necrosis are common findings.\nContrast nephropathy is thought to occur from a combination of factors 1.\nHypoxia in the renal outer medulla due to perturbations in renal microcirculation and occlusion of small vessels Q 2.\nCytotoxic damage to the tubules directly or via the generation of oxygen free radicalsQ, especially since the concentration of the agent within the tubule is markedly increased 3.\nTransient tubule obstruction with precipitated contrast material Q", 'role': 'assistant'}]