Contrast Induce Nephropathy
- Contrast-induced nephropathy (CIN) is associated with a rapid and often
irreversible decline in kidney function following the administration of
iodinated contrast agents.
- CIN is the third leading cause of acute kidney injury (acute renal
failure) in hospitalized patients, and substantially increases mortality,
morbidity, and length of hospitalization.
- It follows a predictable time of onset and is potentially preventable.
- No consensus exists on the definition of CIN, but recent literature
has defined it as an increase in serum creatinine ≥0.5 mg/dL, or more
than 25% above baseline.
- Prevention of At-Risk Patients BEFORE a Dye Study
- Stop all diuretics, ACE-I/ARB, & metformin
- Isotonic solution IV hydration
– Favored over hypotonic solutions & oral hydration
- Alkalinize the urine
– D5W with 3 amps NaHCO3 1cc/kg/hr at least 4-6 hrs prior to exam
– 1/4NS with 2 amps NaHCO3 (patients with diabetes)
- Acetylcysteine 1200 mg PO bid the day before and the day of the
– Lower risk of CIN, compared with 600-mg doses (3.5% versus 11%).
- Treatment of Contrast-induced nephropathy