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Contrast Induced Acute Kidney Injury (CI- AKI) - Myths and Realities
Kulwant Singh1, Vinant Bhargava2, Jyoti E Brar3
1Consultant, Department of Renal Sciences, Ivy Hospital, Mohali, Punjab.
The Journal of the Association of Physicians of India
|November 16, 2021
Summary
Contrast Induced Acute Kidney Injury (CI-AKI) is a common hospital complication. Intravenous fluid hydration is the only proven prevention method, while other agents and hemodialysis are not recommended.
Area of Science:
- Nephrology
- Radiology
- Cardiology
Background:
- Contrast Induced Acute Kidney Injury (CI-AKI) is a frequent complication in hospitalized patients undergoing procedures with contrast agents.
- Risk factors for CI-AKI include advanced age, diabetes, heart failure, proteinuria, and hypotension.
Purpose of the Study:
- To review current strategies for preventing CI-AKI.
- To evaluate the efficacy of various preventative agents and procedures.
Main Methods:
- Review of existing literature on CI-AKI prevention.
- Analysis of recommended and non-recommended prophylactic strategies.
Main Results:
- Intravenous fluid hydration with crystalloids is the sole recommended preventive measure for CI-AKI.
- Agents such as N-acetylcysteine, atrial natriuretic peptide, ascorbic acid, theophylline, and fenoldopam have not demonstrated a proven benefit.
- Prophylactic hemodialysis is not recommended for CI-AKI prevention.
Conclusions:
- Current evidence supports intravenous fluid hydration as the primary strategy for preventing CI-AKI.
- Many previously investigated agents and hemodialysis lack proven efficacy in CI-AKI prevention.
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