Prevention of contrast-induced nephropathy: an overview.
Many unknowns remain concerning how best to reduce a patient's risk of contrast-induced nephropathy (CIN). Many interventions have been proposed, but few have gone unchallenged, and new questions have arisen from analysis of serum creatinine variations in patients who have not been exposed to radiographic iodinated contrast media (RICM). Use of alternate imaging tests that do not use RICM is the most direct way to avoid CIN. Hydration remains the bulwark of intervention when RICM must be administered. The administration of N-acetylcysteine is a popular pharmacologic prophylaxis against CIN but its efficacy is unclear. Hemodialysis has not been effective, but hemofiltration has shown good results in limited series.
Ellis
James H
JH
Department of Radiology, University of Michigan Health System, B1-D502 University Hospital, SPC 5030, 1500 E. Medical Center Drive, Ann Arbor, Michigan 48109-5030, USA. jimellis@umich.edu
Cohan
Richard H
RH
D000111:Acetylcysteine / Q000627:therapeutic use; D003287:Contrast Media / Q000008:administration & dosage / Q000009:adverse effects*; D003404:Creatinine / Q000097:blood; D005440:Fluid Therapy; D006440:Hemofiltration; D006801:Humans; D007674:Kidney Diseases / Q000139:chemically induced* / Q000517:prevention & control*; D007677:Kidney Function Tests; D011292:Premedication
D003287:Contrast Media; D003404:Creatinine; D000111:Acetylcysteine