Table of Contents
Advances in Nephrology
Volume 2014, Article ID 691623, 11 pages
http://dx.doi.org/10.1155/2014/691623
Review Article

The Choice of the Iodinated Radiographic Contrast Media to Prevent Contrast-Induced Nephropathy

1Nephrology Unit, Department of “Health Sciences”, “Magna Graecia” University, Campus “Salvatore Venuta”, Viale Europa, loc. Germaneto, 88100 Catanzaro, Italy
2Nephrology Unit, Department of “Public Health”, “Federico II” University, Via Pansini No. 5, 80131 Naples, Italy

Received 11 June 2014; Revised 31 August 2014; Accepted 8 September 2014; Published 15 October 2014

Academic Editor: Jane Black

Copyright © 2014 Michele Andreucci et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

In patients with preexisting renal impairment, particularly those who are diabetic, the iodinated radiographic contrast media may cause contrast-induced nephropathy (CIN) or contrast-induced acute kidney injury (CI-AKI), that is, an acute renal failure (ARF), usually nonoliguric and asymptomatic, occurring 24 to 72 hours after their intravascular injection in the absence of an alternative aetiology. Radiographic contrast media have different osmolalities and viscosities. They have also a different nephrotoxicity. In order to prevent CIN, the least nephrotoxic contrast media should be chosen, at the lowest dosage possible. Other prevention measures should include discontinuation of potentially nephrotoxic drugs, adequate hydration with i.v. infusion of either normal saline or bicarbonate solution, and eventually use of antioxidants, such as N-acetylcysteine, and statins.