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Jan 26, 2009Article Details
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Main Article Content
Practical issues in the prevention and treatment of contrast nephrotoxity
Abstract
Kidney dysfunction is a serious complication that can occur following the administration of contrast media (CM). Although the incidence of contrast nephropathy
(CN) is low in the general population (1 - 2%) it poses a serious risk to those with impaired kidney function. Other risks include diabetes, old age and dehydration. The first step in prevention is to identify patients at risk. In such patients a small dose of non-ionic iso-osmolar CM together with adequate hydration (preferably an intravenous infusion of 0.45% or 0.9% normal saline) and oral N-acetylcysteine (NAC) dramatically reduces CN. Although
the disease occurs infrequently with normal kidney function, its frequency increases
with decreasing kidney function, ranging from 5% in patients with mild kidney
insufficiency to 50% in those with severe dysfunction and diabetes. Given that CN is
associated with increased morbidity, mortality and prolonged hospitalisation, and
possibly with long-term kidney impairment, there is great interest in its prevention.
South African Journal of Radiology Vol. 9 (3) 2005: pp. 14-16
