The Smart Drip-Feed: A Powerful Strategy to Prevent Contrast Induced Nephropathy

Abstract

Contrast-induced nephropathy (CIN) frequently affects patients with chronic kidney disease and heart dysfunction, patients older than 65 years and patients with diabetes mellitus, multiple myeloma and sepsis. It is often related to the use of high doses of contrast medium. Vasodilators and antioxidant drugs may have positive effects on the prevention of this clinical condition. One of the most important strategies for the prevention of contrast induced nephropathy is an adequate hydration of the patient, with subsequent intravascular volume expansion, renin-angiotensin system suppression, reduced vasoconstriction and renal hypoperfusion. Anyway, an active diuresis is the most important condition for the prevention of CIN. A new system, called RenalGuard®, has been recently proposed to prevent acute kidney injury secondary to the administration of the contrast medium. In this review, we have analyzed the different strategies in the prevention of CIN and the use of RenalGuard® system.