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The global growing number of contrast-enhanced procedures highlights the risk of contrast media–induced renal damage. This review is an effort to define contrast-induced nephropathy and its pathogenesis, weigh its principal risk factors, give some clarifications about kidney function evaluation tools, acquire some clinical relevance prognostic concerns, and bring into focus preventive measures, with special regard to cancer patients. Our final purpose is focused on the request of diagnostic safety in high-risk patients, which may be achieved without unfair differences in this subgroup, too. A second reading of the scientific evidence may offer a chance to tear down the kidney damage ghost, replacing it with the consciousness of a still existing challenge that engages more than one specialty.