Contrast-induced nephropathy: prevention strategies

Abstract

Contrast-induced nephropathy is defined as worsening in renal function after administration of intravenous contrast and ex-clusion of other causes. Contrast-induced nephropathy is usually manifested as an acute non-oliguric renal failure. Cases of con-trast-induced nephropathy are usually defined by a fixed (0.5 mg/dl) or proportionate (25-50%) rise in serum creatinine levels 24-48 hours after exposure to the contrast medium, in the absence of other causes of renal function impairment. Prevention strategies are based on the correction of factors leading to the development of contrast-induced nephropathy and are divided into choice of less nephrotoxic contrast (non-ionic); improvement in the patient’s clinical status through hydration; use of drugs that reduce renal vaso-constriction and oxidative stress; and temporary suspension of drugs with nephrotoxic potential or that are harmful in case of re-duced glomerular filtration. The development of a protocol with preventive strategies for risk patients, especially in diabetics submit-ted to potentially nephrotoxic contrast can reduce morbidity and associated costs to its development. This review aims at describing the definition and pathogenesis of contrast-induced nephropathy, focusing on the main management recommendations to prevent its occurrence.