Author(s): Michele Andreucci,Teresa Faga,and Ashour Michael
Iodinated radiographic contrast agents (IRCA) are pharmaceuticals commonly used for improving the visibility of internal organs and structures in X-ray based imaging techniques such as radiography, angiography and contrast-enhanced computedtomographyscans,andforperformingcardiaccatheterizationsandpercutaneouscoronaryinterventions.Likeallother pharmaceuticals, however, these agents are not completely devoid of risk. The main risk is their nephrotoxicity. Following the description of Contrast-Induced Nephropathy (CIN) and its pathogenesis, the conditions favoring the development of CIN are discussedindepth.Themainpredisposingconditionisapre-existingrenalimpairment,particularlywhenassociatedwithdiabetes mellitus. Then, measures to prevent CIN are suggested. The important rules in CIN prevention are: monitoring renal function, discontinuation of potentially nephrotoxic drugs, use of either iodixanol or iopamidol at the lowest dosage possible. Above all, themainprocedureforpreventionofCINisanadequatehydrationofthepatientwitheitherisotonicsodiumchlorideorsodium bicarbonatesolutions.
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