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Contrast Nephropathy and Kidney Injury

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Textbook of Cardiovascular Intervention

Abstract

CI-AKI is a serious complication for patients undergoing iodinated contrast procedures. CI-AKI has been associated with poor survival, worse morbidity, and increased healthcare resource utilization and cost. There are effective tools to risk-assess patients prior to and following contrast procedures. These tools can be used to identify patients at high risk of developing CI-AKI or renal failure. In order to prevent CI-AKI, aggressive hydration protocols including patient education and at-home hydration, IV normal saline and/or sodium bicarbonate protocols, and consider high-dose N-acetylcysteine (1,200 mg) before and after the procedure. Patients should be educated about the risks of contrast on kidney function and the importance of complying with at-home hydration protocols, post-discharge SCr measurement, and follow-up with cardiology and their primary care physician. These strategies are inexpensive and help to maximize patient safety while reducing overall healthcare expenditures.

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Authors and Affiliations

  1. The Dartmouth Institute for Health Policy and Clinical Practice and Section of Cardiology, Department of Medicine, Community and Family Medicine, Audrey and Theodore Geisel School of Medicine at Dartmouth, HB 7505 DHMC One Medical Center Drive, Lebanon, NH, USA

    Jeremiah R. Brown PhD, MS

  2. St. John Providence Health System, Providence Park Hospital, Cardiovascular Institute, Warren, MI, USA

    Peter A. McCullough MD, MPH

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  1. Jeremiah R. Brown PhD, MS
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Correspondence to Jeremiah R. Brown PhD, MS .

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Editors and Affiliations

  1. Department of Medicine, Cardiology Section, Director, Cardiovascular Catheterization and Intervention, Yale New Haven Hospital, Director, Invasive Cardiology and Vascular Medicine,, New Haven, Connecticut, USA

    Craig A. Thompson

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Brown, J.R., McCullough, P.A. (2014). Contrast Nephropathy and Kidney Injury. In: Thompson, C. (eds) Textbook of Cardiovascular Intervention. Springer, London. https://doi.org/10.1007/978-1-4471-4528-8_5

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  • DOI: https://doi.org/10.1007/978-1-4471-4528-8_5

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