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5/6th Nephrectomy in Combination with High Salt Diet and Nitric Oxide Synthase Inhibition to Induce Chronic Kidney Disease in the Lewis Rat
08:50

5/6th Nephrectomy in Combination with High Salt Diet and Nitric Oxide Synthase Inhibition to Induce Chronic Kidney Disease in the Lewis Rat

Published on: July 3, 2013

[Contrast-induced nephropathy]

A Humbert1, S Kissling, D Teta

  • 1Service de néphrologie et consultation d'hypertension, Département de médecine interne, CHUV, 1011 Lausanne. antoine.humbert@chuv.ch

Revue Medicale Suisse
|June 27, 2013
PubMed

Insights

Contrast-induced nephropathy, a cause of hospital-acquired acute kidney injury, can be prevented with intravenous fluids. Sodium bicarbonate may be more effective than saline for preventing contrast-induced nephropathy.

Area of Science:

  • Nephrology
  • Radiology
  • Pharmacology

Context:

  • Contrast-induced nephropathy (CIN) is a significant cause of hospital-acquired acute kidney injury.
  • Patients with specific risk factors are particularly susceptible to CIN, which increases morbidity and mortality.
  • Effective prevention strategies for CIN are crucial in clinical practice.

Purpose:

  • To review the current evidence on the prevention of contrast-induced nephropathy.
  • To compare the efficacy of different intravenous fluid strategies for CIN prevention.
  • To evaluate the role of N-acetylcysteine in CIN prophylaxis.

Summary:

  • Volume expansion with intravenous fluids, specifically sodium chloride 0.9% or sodium bicarbonate 1.4%, is the primary method for preventing contrast-induced nephropathy.
  • Comparative randomized controlled trials suggest a potential benefit of sodium bicarbonate over saline in preventing CIN.
  • Current evidence indicates that N-acetylcysteine does not offer additional protective benefits when used with intravenous fluids for CIN prevention.

Impact:

  • Highlights the importance of appropriate fluid management in patients undergoing procedures with contrast media.
  • Suggests a preferred intravenous fluid (sodium bicarbonate) for CIN prevention based on available evidence.
  • Informs clinical decision-making regarding the use of N-acetylcysteine, advising against its routine use for CIN prophylaxis.

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