All of the following are risks for contrast-induced acute renal failure EXCEPT:

The correct answer relates to the use of low-osmolar contrast agents, which are recognized for their reduced risk of inducing contrast-induced acute renal failure compared to high-osmolar contrast agents. Low-osmolar contrast media typically result in fewer adverse reactions and have a lower nephrotoxic profile, making them a preferred choice in patients who may be at risk for renal complications.

In contrast, dehydration, longstanding hypertension, and multiple myeloma are all significant risk factors for developing contrast-induced renal failure. Dehydration can lead to reduced renal perfusion, increasing the susceptibility of the kidneys to damage from contrast media. Longstanding hypertension is associated with chronic kidney disease, thus making the kidneys more vulnerable to the harms of contrast. Multiple myeloma can lead to increased levels of free light chains in the blood, which can precipitate renal injury, especially in conjunction with contrast administration.

The understanding of the relative safety of low-osmolar contrast is critical in the context of protecting renal function in at-risk patient populations during imaging studies that necessitate contrast agents.