How is contrast-induced nephropathy (CIN) prevented?

Updated: Dec 18, 2018
  • Author: Anita Basu, MD, FACP; Chief Editor: Vecihi Batuman, MD, FASN  more...
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Answer

Prevention centers around avoiding volume depletion. This has led to trials and practices using oral hydration, volume expansion with IV fluids and bicarbonate, and both holding and using diuretics. Other prevention strategies include using alternate imaging methods, minimizing amount of contrast, using iso-osmolar nonionic contrast agents, and administration of the antioxidant acetylcysteine. Routinely holding medications such as angiotensin-converting enzyme inhibitors (ACEIs) or diuretics is not recommended. However, one should try to hold any medication that could be nephrotoxic, such as nonsteroidal anti-inflammatory drugs (NSAIDs). Preemptive hemodialysis or hemodiafiltration has not shown to be of any benefit and is not recommended.


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