Prevention of Contrast-Induced Acute Kidney Injury: an Update

Cardiovasc Drugs Ther. 2016 Oct;30(5):515-524. doi: 10.1007/s10557-016-6683-0.

Abstract

Contrast-induced acute kidney injury (CI-AKI) is a common complication of intravascular administration of contrast media used in coronary angiography, percutaneous coronary intervention and other diagnostic and interventional procedures. This review article aims at summarizing the published literature regarding the prevention of CI-AKI, by focusing on available high-quality meta-analyses addressing this matter. Apart from adequate hydration, a number of pharmacologic agents have been proposed as potential candidates to be included in the routine preparation, prior to the patient's arrival in the cardiac catheterization laboratory. Among them, statins and N-acetylcysteine appear to be the most extensively studied ones. Throughout this article we present the available data on CI-AKI prevention and provide a critical clinical appraisal, as well as a summary of currently available guidelines.

Keywords: Acute kidney injury; Contrast induced nephropathy; Contrast media; Coronary angiography; Percutaneous coronary intervention; Prevention.

Publication types

  • Review

MeSH terms

  • Acetylcysteine / therapeutic use
  • Acute Kidney Injury / chemically induced*
  • Acute Kidney Injury / prevention & control*
  • Aminophylline / therapeutic use
  • Animals
  • Ascorbic Acid / therapeutic use
  • Contrast Media / adverse effects*
  • Humans
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / therapeutic use
  • Purinergic P1 Receptor Agonists / therapeutic use
  • Theophylline / therapeutic use

Substances

  • Contrast Media
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors
  • Purinergic P1 Receptor Agonists
  • Aminophylline
  • Theophylline
  • Ascorbic Acid
  • Acetylcysteine