How to reduce the incidence of contrast induced acute kidney injury after cardiac (invasive) procedures, a review and practical recommendations

Abstract

Background:

Contrast induced acute kidney injury is an important complication after cardiac (invasive) procedures and is associated with substantial morbidity and mortality. The aim of the current article is to provide a comprehensive overview of the current knowledge regarding contrast induced acute kidney injury.

Methods:

Current literature was reviewed and relevant articles were selected. Articles were identified through MEDLINE and Pubmed selecting articles, limited between 1980 and 2010.

Results:

The pathophysiological process resulting in contrast induced acute kidney injury is not completely understood, nevertheless several mechanisms involved have been proposed. However, the risk factors for contrast induced acute kidney injury and its timing are well known, making it amenable for preventive strategies. In the past decade various preventive strategies have been investigated with different results.

Conclusions:

Currently, only adequate hydration, with saline, is uniformly accepted as a beneficial prophylactic strategy. Furthermore promising results have also been reported for several other prophylactic strategies. These results, however, need to be confirmed in future trials.

Key words::

• Cardiac (invasive) procedures
• Contrast induced acute kidney injury
• Contrast induced nephropathy
• Contrast media

Transparency

Declaration of funding

This study was funded by the department of Cardiology of the Leiden University Medical Center.

Declaration of financial/other relationships

C.A.H. is on the scientific advisory board of CorMedix. M.K.d.B., J.B.v.R., T.J.R., M.J.S. and J.W.J. have disclosed that they have no relevant financial relationships.

CMRO peer reviewers may have received honoraria for their review work. The peer reviewers on this manuscript have disclosed that they have no relevant financial relationships.