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).