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Nephroprotection and iodinate contrast medias

C Sebastià1, S Falip1, R Crespo1

  • 1Servicio de Radiodiagnóstico, Hospital Clínic de Barcelona, Barcelona, Spain.

Radiologia
|November 27, 2024
PubMed

Insights

Post-contrast acute kidney injury (PC-AKI) is rare with modern contrast agents. Hydration, either oral or intravenous, is the key to preventing PC-AKI, alongside updated, less restrictive fasting guidelines.

Area of Science:

  • Nephrology
  • Radiology
  • Pharmacology

Background:

  • Post-contrast acute kidney injury (PC-AKI) incidence is low with newer low- or iso-osmolar non-ionic iodinated contrast agents.
  • Hydration is the sole established method for PC-AKI prophylaxis, with both intravenous and oral routes demonstrating equal efficacy.

Purpose of the Study:

  • To define PC-AKI and its associated risk factors.
  • To propose a standardized prophylaxis protocol for PC-AKI.
  • To provide updated fasting guidelines for contrast-enhanced imaging procedures.

Main Methods:

  • Review of current literature on PC-AKI and contrast agent properties.
  • Development of a clinical protocol for PC-AKI prophylaxis.
  • Analysis of fasting recommendations in relation to contrast media administration.

Main Results:

  • Newer contrast agents are associated with a low incidence of PC-AKI.
  • Oral hydration is as effective as intravenous hydration for PC-AKI prevention.
  • Fasting is generally not required for contrast procedures, simplifying patient preparation and aiding hydration.

Conclusions:

  • PC-AKI prophylaxis relies on hydration and updated, less stringent fasting protocols.
  • The updated guidelines facilitate oral hydration, thereby reducing PC-AKI incidence.
  • These evidence-based recommendations aim to optimize patient safety during contrast-enhanced examinations.

Keywords:
Best practiceContrast mediaContraste yodadoIodinate contrast mediaMedio de contrasteMejor prácticaProfessional practicePráctica profesionalRadiologyRadiología

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