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BioMed Research International
Volume 2014, Article ID 423848, 7 pages
Review Article

ACE-I/ARB Therapy prior to Contrast Exposure: What Should the Clinician Do?

1Makerere University College of Health Sciences, 7072 Kampala, Uganda
2Section of Nephrology, Yale University School of Medicine, New Haven, CT 06520, USA

Received 17 October 2013; Accepted 10 December 2013; Published 29 January 2014

Academic Editor: Michele Andreucci

Copyright © 2014 Robert Kalyesubula 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.


Contrast-induced nephropathy (CIN) is now one of the three leading causes of acute kidney injury in the world. A lot is known about the risk factors of CIN, yet it remains a major cause of morbidity, end stage renal disease, prolonged hospital stay, and increased costs as well as a high mortality. Many patients undergoing contrast-based radiological investigations are treated with angiotensin converting inhibitors (ACE-Is) or angiotensin receptor blockers (ARBs) for their cardiac and renal benefits and their known mortality benefits. However, controversy exists among clinicians as to whether ACE-Is and ARBs should be continued or discontinued prior to contrast media exposure. In this paper we review the current evidence on ACE-I/ARB therapy for patients undergoing procedures involving use of contrast media and provide recommendations as to whether these drugs should be continued or held prior to contrast exposure.