Past and present attempts to prevent radiocontrast nephropathy

Radiocontrast nephropathy is an under-recognized event after coronary and radiographic angiography, with major morbidity and mortality. Patients at greatest risk for RCN can be defined prior to the procedure based on age, presence of diabetes, and presence of preexisting renal dysfunction. Despite attempts to alter preprocedural hydration, amount of dye administered, and postprocedural therapies, this clinical event continues to affect over 25% of patients at high risk. This discussion will review the literature in order to understand the attempts that have been made to prevent radiocontrast nephropathy.