Does a patient with kidney disease require special preparation before an imaging test with intravenous iodine contrast? What about a patient without kidney disease?
Jürgen Floege, MD: If you come in, have a diagnostic test, and have normal renal function, there is no special preparation. But even in the patient with chronic kidney disease we step down the further we go. We no longer use aggressive hydration, we no longer use acetylcysteine, we have never used bicarbonate.
The basic take-home message nowadays is that you should not give radiocontrast agents when you are hypovolemic, dehydrated, or in shock. In all other situations it simply does not matter as long as you keep the volume down. The gut feeling says that a contrast volume of 100 mL is usually safe, and this is what you need for a typical computed tomography (CT) scan or a well-done coronary angiography. You can get most of your tests done with that volume.