[Is dialysis efficient in the prevention of ionic contrast agent-induced nephropathy?].
A FREQUENT AND EXPENSIVE PROBLEM: Ninety percent of contrast media nephrotoxicity (CMN) occur in patients with pre-existing kidney failure. Its aggravation may require early chronic dialysis.


RESULTS
CMN prophylaxis is important in these patients. Pre- and post-hydration, with infusion of isotonic saline solution or sodium bicarbonate, and reduction of contrast medium (CM) volume to the strict minimum are essential for preventing CM-induced kidney failure. THE INTEREST OF PROPHYLACTIC HEMODIALYSIS AND HEMOFILTRATION: An interesting approach in preventing CMN is the early elimination of the CM with dialysis techniques. Preventive hemodialysis does not reduce the risk of CMN, but hemofiltration has shown significant efficacy in a population of patients with kidney failure. THE INTEREST OF IMMEDIATE HEMODIALYSIS IN CHRONIC HEMODIALYSIS PATIENTS: Although nephrotoxicity is no longer a problem in patients undergoing chronic hemodialysis, CM, especially in high-dose injections, may be responsible for fluid and electrolyte abnormalities and/or volemic expansion. No data yet justify a conclusion that a hemodialysis session immediately after injection of a CM in chronic dialysis patients might be helpful.
Karie
Svetlana
S
Service de néphrologie, Groupe hospitalier Pitié-Salpêtrière 83, boulevard de I'hôpital, 75013 Paris, France. svetlana.karie@psl.aphp.fr
Launay-Vacher
Vincent
V
Izzedine
Hassan
H
Deray
Gilbert
G
D003287:Contrast Media / Q000009:adverse effects*; D006801:Humans; D017613:Iodine Compounds / Q000009:adverse effects*; D007674:Kidney Diseases / Q000139:chemically induced* / Q000517:prevention & control*; D006435:Renal Dialysis
D003287:Contrast Media; D017613:Iodine Compounds