Current trials of interventions to prevent radiocontrast-induced nephropathy.
Radiocontrast administration is a common cause of hospital-acquired acute renal failure. It is associated with significant in-hospital and long-term morbidity and mortality and increases the costs of medical care by at least extending the hospital stay. A variety of therapeutic interventions, including saline hydration, diuretics, mannitol, calcium channel antagonists, theophylline, endothelin receptor antagonists, and dopamine, have been employed to prevent radiocontrast-induced acute renal failure. Recent advances have examined the impact of fenoldopam (dopamine-1 receptor agonist), N-acetylcysteine (antioxidant), iso-osmolar contrast agents, hemodialysis, and hemofiltration on ameliorating radiocontrast-induced acute renal failure. Although hydration with half-normal saline had remained the gold standard for the prevention of radiocontrast-induced nephropathy, recent data have revealed the superiority of hydration with normal saline over half-normal saline. This review focuses on the most recent studies of interventions to ameliorate radiocontrast-induced acute renal failure and provides a critical analysis of some of the recent studies conducted to prevent radiocontrast-induced nephropathy.
Asif
Arif
A
Division of Nephrology and Hypertension, Department of Medicine, University of Miami School of Medicine, 1600 NW 10th Avenue (R 7168), Miami, FL 33136, USA.
Garces
Galo
G
Preston
Richard A
RA
Roth
David
D
D000111:Acetylcysteine / Q000627:therapeutic use; D058186:Acute Kidney Injury / Q000139:chemically induced* / Q000517:prevention & control*; D000975:Antioxidants / Q000627:therapeutic use; D002986:Clinical Trials as Topic; D003287:Contrast Media / Q000009:adverse effects* / Q000737:chemistry; D018491:Dopamine Agonists / Q000627:therapeutic use; D018818:Fenoldopam / Q000627:therapeutic use; D006801:Humans; D007552:Isotonic Solutions; D009994:Osmolar Concentration; D017447:Receptors, Dopamine D1 / Q000819:agonists; D017693:Sodium Bicarbonate / Q000627:therapeutic use; D012965:Sodium Chloride / Q000008:administration & dosage
D000975:Antioxidants; D003287:Contrast Media; D018491:Dopamine Agonists; D007552:Isotonic Solutions; D017447:Receptors, Dopamine D1; D012965:Sodium Chloride; D017693:Sodium Bicarbonate; D018818:Fenoldopam; D000111:Acetylcysteine