|The following article features coverage from the National Kidney Foundation’s virtual 2020 Spring Clinical Meetings. Click here to read more of Renal and Urology News’ conference coverage.|
Investigators have developed a shorter protocol for preventing contrast-induced acute kidney injury (AKI) in patients with stage 4 chronic kidney disease that could eliminate the need for post-imaging intravenous hydration, according to a poster presentation at the live-virtual 2020 National Kidney Foundation Spring Clinical Meetings.
The finding is from a quality improvement project established at the James A. Haley Veterans Hospital in Tampa, Florida, to determine whether a shorter protocol would be as effective as standard protocols in preventing contrast-induced AKI in patients with stage 4 CKD.
One of the most commonly used hydration protocols consists of 3 mL/kg of normal saline (NS) IV bolus 1 hour before iodinated contrast study followed by 1-1.5 mg/kg for 4-6 hours after the study, investigators Sameer Alqassimi, MD, and colleagues noted in a poster presentation.
The novel shorter protocol consisted of instructing patients to drink 64 ounces of fluids the day before, the day of, and the day after the CT scans, the investigators explained. Water was the fluid of choice.
The study cohort consisted of 23 patients who received 250 mL/hour of NS IV for 2 hours prior to their CT scans. Serum creatinine and cystatin C measurements were available within 30 days prior to the contrast studies. The investigators obtained serum creatinine and cystatin C measurements within 36 to 48 hours after the studies. Stage 1 AKI according to the KDIGO [Kidney Disease: Improving Global Outcomes] definition developed in only 1 patient (4.35%).
The protocol is not inferior compared with prior published studies, which show an AKI incidence ranging from 2.5% to 15.3%, according to the investigators.
“Due to the high number of iodinated CT scan studies, a shorter and effective CIN [contrast-induced nephropathy] prophylaxis protocol would be ideal as it would save time and resources,” the investigators concluded.
Read more of our coverage of the National Kidney Foundation’s virtual 2020 Spring Clinical Meetings by visiting the conference page.
Alqassimi S, Peguero A, Lamarche J, et al. Cost effective method to prevent contrast induced acute kidney injury. Data presented at the live-virtual 2020 National Kidney Foundation Spring Clinical Meetings held March 25 to 28. ePoster 2.