Forced diuresis with the RenalGuard system: impact on contrast induced acute kidney injury.
Kidney injury following the administration of iodinated contrast media occurs particularly in patients with reduced kidney and cardiac function and when large doses of contrast are used. There is little compelling evidence that vasodilators and anti-oxidants prevent this injury. Most prevention trials have employed intravenous volume loading as a central strategy. However, the success of this approach depends upon maintaining euvolemia while producing a vigorous diuresis. A novel strategy for maintaining euvolemia and inducing a vigorous diuresis has been developed using the RenalGuard system. In this review; the mechanism of protective action is reviewed. The trials of the RenalGuard device are reviewed and future uses of the device are discussed.
University of Vermont College of Medicine, USA; Fletcher Allen Health Care, USA. Electronic address: Richard.solomon@vtmednet.org.
Richard
R
Solomon
D058186:Acute Kidney Injury / Q000139:chemically induced* / Q000517:prevention & control*; D003287:Contrast Media / Q000009:adverse effects*; D004231:Diuresis / Q000187:drug effects / Q000502:physiology; D004232:Diuretics / Q000008:administration & dosage* / Q000494:pharmacology; D005665:Furosemide / Q000008:administration & dosage* / Q000494:pharmacology; D006801:Humans; D010865:Pilot Projects; D016032:Randomized Controlled Trials as Topic; D013997:Time Factors; D014546:Urinary Catheterization / Q000379:methods
D003287:Contrast Media; D004232:Diuretics; D005665:Furosemide
Acute kidney injury; Contrast media; Coronary angiography; Diuresis