Could torasemide be a prophylactic agent of contrast induced acute kidney injury? A review about this field.

Abstract Contrast Induced Acute Kidney Injury (CI-AKI), due to the use of contrast media in radiographic procedures, is the leading cause of acute renal failure in hospitalized patients, and is associated with prolonged in-hospital stay and increased morbidity, mortality, and costs. However only peri-procedural hydration is now used universally as its preventive strategy. Some studies indicates that renin-angiotensin-aldosterone system (RAAS) is possibly responsible for the development of contrast-induced nephrotoxicity through mediating abnormalities of renal perfusion and other mechanisms. And torasemide, known as loop diuretics, could inhibit RAAS through its anti-aldosteronergic function. Therefore, speculation about torasemide's prevention of CI-AKI could be firmly made. Intravenously administrated torasemide would be promising as a future prophylactic agent, possibly in combination with other strategies such as adequate peri-procedural hydration and other renal protective agents, in the prevention of CI-AKI. In this context, we review the background and the role of RAAS on the development of CI-AKI, and discuss the pharmacologic individuality of torasemide on RAAS and torasemide's preventive effect on CI-AKI.