A review of current strategies for preventing CIN in at-risk patients

Abstract

Various strategies have been used for the prevention of contrast-induced nephropathy (CIN) in patients at risk. Concurrent use of nephrotoxic medications should be avoided for 24 to 48 h before administration of contrast agents. In addition, patients should be well hydrated before the imaging procedure. Recent data suggest that intravenous hydration is preferable to oral, and isotonic saline is more effective in preventing CIN than half-isotonic saline. Pharmacological interventions, such as calcium-channel blockers, dopamine, fenoldopam and atrial natriuretic peptide, have not been proven to prevent CIN. While N-acetylcysteine and theophylline may be beneficial, results are inconsistent across trials. Adoption of these precautionary measures is appropriate for reducing the incidence of CIN in patients at risk.