Saturday October 8, 2005
Preventing contrast-Induced Nephropathy
Except for IV hydration so far no strategy has proved of clear cut benefit in preventing Radiocontrast-Induced Nephropathy including famous Mucomyst (N-Acetylcysteine). But it is interesting to know that a recent randomized controlled trial has shown that: "Hydration with sodium bicarbonate before contrast exposure is more effective than only hydration with saline in prophylaxis of contrast-induced renal failure"1.
All patients undergoing contrasted studies should be volume replete with saline 1 mL/kg/h for at least 12 hours before and after the procedure - warranting clinical judgment.
Recommended reading: Click on link to go to reference.
1. Prevention of Contrast-Induced Nephropathy With Sodium Bicarbonate - JAMA 2004;292:1428-1428. (full text available with free reg.)
2. N-Acetylcysteine and Radiocontrast-Induced Nephropathy - Jeff S. Rose, MD