The Prevention of Contrast-Induced Nephropathy

Trang H. Au, Anne Bruckner, Syed M. Mohiuddin, Daniel E. Hilleman

Research output: Contribution to journalReview article

28 Citations (Scopus)

Abstract

Objective: Contrast-induced nephropathy (CIN) is a complication which may develop after exposure to iodinated contrast media. The resulting acute kidney injury (AKI) is associated with an increase in both short- and long-term morbidity and mortality, increased hospital length of stay, and greater health care costs. The pathophysiological mechanism associated with the development of CIN remains unknown. This narrative review summarizes the pathophysiology, risk factors, and current evidence for the prevention of CIN. Data Sources: A MEDLINE literature search (2004-May 2014) was performed using search terms contrast-induced nephropathy and prevention. Additional references were identified from literature citations, review articles, and meta-analyses. Study Selection and Data Extraction: Abstracts of English-language human clinical trials that examined therapies for the prevention of CIN were evaluated. Studies that did not investigate a preventative intervention for CIN were excluded. Emphasis was placed on recent publications. Data Synthesis: A multitude of therapies focused on the prevention of CIN have been investigated. Unfortunately, many of these studies have produced negative and/or inconsistent results. There is a paucity of adequately designed clinical studies evaluating strategies for the prevention of CIN. However, the best data supports use of preprocedural hydration with isotonic solution as the standard of care for prophylaxis. Conclusion: Given the poor prognosis associated with CIN, there is need for improved methods to prevent it. At present, the best tools to protect patients from unnecessary risk for CIN are careful assessment of renal function, judicious use of procedures that utilize contrast media, and adequate hydration with isotonic solution.

Original languageEnglish
Pages (from-to)1332-1342
Number of pages11
JournalAnnals of Pharmacotherapy
Volume48
Issue number10
DOIs
StatePublished - 2014

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Isotonic Solutions
Contrast Media
Length of Stay
Information Storage and Retrieval
Standard of Care
Acute Kidney Injury
MEDLINE
Health Care Costs
Meta-Analysis
Language
Clinical Trials
Morbidity
Kidney
Mortality
Therapeutics
Clinical Studies

All Science Journal Classification (ASJC) codes

  • Pharmacology (medical)
  • Medicine(all)

Cite this

The Prevention of Contrast-Induced Nephropathy. / Au, Trang H.; Bruckner, Anne; Mohiuddin, Syed M.; Hilleman, Daniel E.

In: Annals of Pharmacotherapy, Vol. 48, No. 10, 2014, p. 1332-1342.

Research output: Contribution to journalReview article

Au, Trang H. ; Bruckner, Anne ; Mohiuddin, Syed M. ; Hilleman, Daniel E. / The Prevention of Contrast-Induced Nephropathy. In: Annals of Pharmacotherapy. 2014 ; Vol. 48, No. 10. pp. 1332-1342.
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