Prophylaxis in patients at risk of contrast-induced AKI

What prophylaxis do you recommend for a patient at increased risk for contrast-induced acute kidney injury?

Jürgen Floege, MD: None other than making certain that my patient is reasonably well hydrated—not overhydrated. In trials they have seen that if you aggressively hydrate patients, you will have some that will develop acute heart failure; this is something clearly to avoid.

On the other hand, you do not want to do this test when you have a severely dehydrated patient with vomiting or diarrhea, etcetera. It is the same topic again (see Preparation before IV iodine contrast).

See also

Preparation before IV iodine contrast Does a patient with kidney disease require special preparation before an imaging test with intravenous iodine contrast? What about a patient without kidney disease?
PoCUS and volume status examination What is the best way to assess volume status?
First steps in suspected sepsis What should be our first steps when we suspect sepsis?
Fluid resuscitation in the early management of septic shock What are the current guidelines for fluid resuscitation in the early management of patients with septic shock?
Improving organ donation rates How to improve organ donation rates?
Nephrotic syndrome in adults: current management A lecture by Dr Jürgen Floege, from RWTH Aachen University, Germany, delivered at McMaster International Review Course in Internal Medicine in Kraków in May 2017.
NNT, NNF, fragility index, CI: how to understand these numbers A lecture by Dr P.J. Devereaux delivered at Evidence-Based Medicine and Clinical Practice Guidelines in Contemporary Practice in Kraków in May 2017.
Mineral and bone disorders in chronic kidney disease: what should the internist know A lecture by Prof. Jürgen Floege, from RWTH Aachen University, Germany, delivered at McMaster International Review Course in Internal Medicine in Kraków in May 2016.

Prophylaxis in patients at risk of contrast-induced AKI

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