Contrast imaging techniques and renal dysfunction

Iodinated contrast has been one of the most prescribed and used drugs in contrast imaging techniques and interventional procedures However some subjects may develop contrast induced nephropathy CIN especially those in advanced chronic kidney disease CKD Diagnostic criterion is based on increasing h creatinine after receiving iodine Given the fact that there is no specific treatment for CIN prevention should be considered Uncountable actions should be taken including reducing the dose using a low osmolar substance avoiding dehydration and other nephrotoxic drugs Currently prevention has been based on using saline solution A recent paper showed that for patients with stage and of CKD sodium bicarbonate did not provided greater benefit when compared to a saline solution as well as comparing acetylcysteine to placebo Regarding to gadolinium besides nephrotoxicity is irrelevant there is a risk for developing Nephrogenic Systemic Fibrosis NSF which may occur in those with GFR lt mL min particularly appears at a GFR lt mL min Current gadolinium use guidelines are related to patients with stage GFR lt mL min according to which they should undergo hemodialysis after examination