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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
PubMed

Insights

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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