Experts say risk overstated for use of IV iodinated contrast media in patients with reduced renal function.
Serum hepcidin rises significantly as early as 4 and 8 hours after percutaneous coronary intervention.
The risk of post-contrast acute kidney injury increased with decreasing renal function.
No patient had a 25% or greater rise in serum creatinine 48 hours after receiving a median 13 mL of contrast for diagnostic coronary angiography, with an additional 13 mL for percutaneous coronary intervention.
Nicorandil significantly reduced contrast-induced nephropathy by 62%, compared with controls.
Contrast-associated acute kidney injury occurred in 9.5% and 9.1% of patients receiving IV sodium bicarbonate and acetylcysteine, respectively, rates which did not differ significantly from the 8.3% rate among those receiving IV sodium chloride.
In a phase 3 trial, acute kidney injury developed in 13.2% of patients undergoing invasive coronary angiography compared with 5.6% of those undergoing computed tomography angiography.
AKI occurred with similar frequency among patients who did and did not receive contrast medium.
Risk factors include impaired renal function and inadequate hydration prior to contrast exposure.
High-risk patients who did not receive guidelines-recommended prophylactic hydration prior to procedures requiring iodinated contrast media had the same rate of contrast-induced nephropathy (CIN) as patients who received usual care, according to results from the phase 3 AMACING trial published online ahead of print in The Lancet.1 CIN refers to the decline in renal function…