title: Prevention of contrast-induced nephropathy through a knowledge of its pathogenesis and risk factors.
abstract: Contrast-induced nephropathy (CIN) is an iatrogenic acute renal failure (ARF) occurring after the intravascular injection of iodinated radiographic contrast media. During the past several years, in many patients undergoing computed tomography, iodinated contrast media have not been used for the fear of ARF, thereby compromising the diagnostic procedure. But recent studies have demonstrated that CIN is rarely occurring in patients with normal renal function and that preexisting chronic renal failure and/or diabetes mellitus represent(s) predisposing condition(s) for its occurrence. After the description of CIN and its epidemiology and pathophysiology, underlying the important role played by dehydration and salt depletion, precautions for prevention of CIN are listed, suggested, and discussed. Maximum priority has to be given to adequate hydration and volume expansion prior to radiographic procedures. Other important precautions include the need for monitoring renal function before, during, and after contrast media injection, discontinuation of potentially nephrotoxic drugs, use of either iodixanol or iopamidol at the lowest dosage possible, and administration of antioxidants. A long list of references is provided that will enable readers a deep evaluation of the topic.
authors.affiliation: Nephrology Unit, Department of Health Sciences, Magna Graecia University, Salvatore Venuta Campus, Viale Europa, Loc. Germaneto, 88100 Catanzaro, Italy.
authors.forename: Michele
authors.identifier: 0000-0002-7974-3792
authors.initials: M
authors.lastname: Andreucci
authors.affiliation: Nephrology Unit, Department of Health Sciences, Magna Graecia University, Salvatore Venuta Campus, Viale Europa, Loc. Germaneto, 88100 Catanzaro, Italy.
authors.forename: Teresa
authors.initials: T
authors.lastname: Faga
authors.affiliation: Nephrology Unit, Department of Public Health, University of Naples Federico II, Via Pansini No. 5, 80131 Naples, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Pisani
authors.affiliation: Nephrology Unit, Department of Public Health, University of Naples Federico II, Via Pansini No. 5, 80131 Naples, Italy.
authors.forename: Massimo
authors.identifier: 0000-0003-1339-9228
authors.initials: M
authors.lastname: Sabbatini
authors.affiliation: Nephrology Unit, Department of Public Health, University of Naples Federico II, Via Pansini No. 5, 80131 Naples, Italy.
authors.forename: Domenico
authors.initials: D
authors.lastname: Russo
authors.affiliation: Nephrology Unit, Department of Health Sciences, Magna Graecia University, Salvatore Venuta Campus, Viale Europa, Loc. Germaneto, 88100 Catanzaro, Italy.
authors.forename: Ashour
authors.initials: A
authors.lastname: Michael
mesh_terms: D000975:Antioxidants / Q000627:therapeutic use; D003287:Contrast Media / Q000009:adverse effects*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007674:Kidney Diseases / Q000139:chemically induced* / Q000453:epidemiology / Q000503:physiopathology / Q000517:prevention & control*; D006435:Renal Dialysis; D012307:Risk Factors
chemical_list: D000975:Antioxidants; D003287:Contrast Media