Progress In Prevention And Trestment Of Contrast-Induced Nephropathy

Contrast-induced nephropathy(CIN) is a common hospital-acquired acute kidney injury. Published studies on this condition have dramatically increased in recent years. This article aims to provide a brief literature review. English articles published were retrieved from PubMed by searching using the term “contrast-induced nephropathy.” CIN is defined as a ≥0.5 mg/d L rise in serum creatinine or a 25% increase, assessed within48-72 hours after administration of contrast medium(CM). Patients with CIN were associated with increased resource utilization, prolonged hospital stay, and increased long-term mortality. All patients receiving CM should be evaluated for their CIN risk, especially preexisting kidney disease. The CM should be prewarmed to 37℃ and injected at the lowest possible dose.Repeat injection within 72 hours should be avoided. Either iso-osmolar CM or low-osmolar CM,can be used in all patients. Nephrotoxic drugs should be stopped 2 days prior to when the patient undergoes a procedure.Parenteral isotonic saline without any diuretic should be started 12 hours prior to CM at a rate of 1 mL/kg/h and continued for 24 hours if there is no contraindication. Oral N-acetylcysteine(600 mg bid, starting on the day prior to the procedure) together with parenteral hydration is suggested for patients at risk. Hemodialysis/hemofiltration is only considered in chronickidney disease stage 4/5 patients when an access is available. CIN is a potentially preventable clinical condition. A careful review of published reports gives us a deeper understanding of CIN and a greater chance of decreasing its risk.