Contrast-induced nephropathy: Pharmacological prophylaxis

• Published in: Kidney international Vol. 69; no. S100; pp. S30 - S38
• Main Authors: Briguori, C., Marenzi, G.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-04-2006; Elsevier Limited
• Subjects: Acetylcysteine - pharmacology; Acute Kidney Injury - chemically induced; Acute Kidney Injury - prevention & control; Antioxidants - pharmacology; Ascorbic Acid - pharmacology; Calcium Channel Blockers - pharmacology; complications; contrast media; Contrast Media - adverse effects; Dopamine - pharmacology; Humans; kidney; Kidney - blood supply; Kidney Diseases - chemically induced; Kidney Diseases - prevention & control; prevention; Randomized Controlled Trials as Topic - statistics & numerical data; Vasoconstriction; kidney; complications; prevention; contrast media
• ISSN: 0085-2538; 0098-6577; 1523-1755
• DOI: 10.1038/sj.ki.5000372

Contrast media-associated acute renal failure represents the third most common cause of in-hospital renal function deterioration after decreased renal perfusion and post-operative renal insufficiency. Although generally benign, this complication is associated with a mortality rate ranging from 3.8 to 64%, depending on the increase of creatinine concentration. Multiple drugs have been tested in an attempt to prevent this complication. Central to the pathophysiology of contrast-induced nephrotoxicity (CIN) is an alteration in renal hemodynamics. In an effort to reverse these hemodynamic changes, vasodilators and diuretics have been tested as prophylactic drugs. However, their effectiveness has not been confirmed. Recently, considerable interest has resulted from the initial positive data on the effectivess of prophylactic administration of antioxidant compounds, such as acetylcysteine and ascorbic acid. In this review, we focus on the effectiveness of pharmacologic therapies for preventing CIN.