Contrast-induced acute kidney injury: the at-risk patient and protective measures.
Contrast-induced acute kidney injury (CI-AKI) is a major complication following radiocontrast procedures. In this review, we characterize the recent literature on CI-AKI, risk factors, prevention, biomarkers, and new technologies. The premise of CI-AKI prophylaxis should focus on implementing mandatory standing orders before and after cardiac catheterization for hydration with normal saline or sodium bicarbonate and use of high-dose (1200-mg) N-acetylcysteine. Contrast agents may play a role in preventing CI-AKI. Implement catheter-laboratory technology and awareness to limit the amount of contrast dye used for any patient.
Brown
Jeremiah R
JR
The Dartmouth Institute for Health Policy and Clinical Practice, Section of Cardiology, Dartmouth Medical School, Hanover, NH, USA.
Thompson
Craig A
CA
D000111:Acetylcysteine / Q000627:therapeutic use; D058186:Acute Kidney Injury / Q000139:chemically induced* / Q000628:therapy; D015415:Biomarkers; D006328:Cardiac Catheterization; D003287:Contrast Media / Q000009:adverse effects*; D004359:Drug Therapy, Combination; D016166:Free Radical Scavengers / Q000627:therapeutic use; D006801:Humans; D006875:Hydrotherapy / Q000379:methods; D018570:Risk Assessment; D012307:Risk Factors; D017693:Sodium Bicarbonate / Q000627:therapeutic use
D015415:Biomarkers; D003287:Contrast Media; D016166:Free Radical Scavengers; D017693:Sodium Bicarbonate; D000111:Acetylcysteine