Yazeed A. Turkistani, Tariq M. Alshami, Saleh J. Almatrafi, Adel O. Alahmadi, Safiah A.H. Al Edrisy, Ghofran Y. Bazuhair, Fatimah H.A. Rajab, Abdullah H.A. Alqawain, Bakr A.S. Jalawi, Shatha A. Hashem, Hussam J. Khinkar, Aya K. Alkhudhairy

Abstract

Background: The risk of contrast-induced acute kidney injury (CI-AKI) has been accepted lately by medical literature and practice since it is the third leading cause of acute kidney injury in hospitalized patients. Different measures in practice are being used to prevent the incidence of CI-AKI. Objective: In this review, we aimed to discuss the different methods of prevention of CI-AKI mentioned in the literature. Methods: A comprehensive search was done using biomedical databases including Medline, and PubMed, for studies concerned with the assessment of Contrast-Induced Acute Kidney Injury. Keywords used in our search through the databases were “Contrast-Induced Kidney Failure” and “Diagnosis & Management”. Conclusion: Intravenous (IV) fluid hydration is the mainstay of practice in the prevention of CI-AKI. Intravenous administration of sodium bicarbonate has also gained notable importance in the prevention of CI-AKI, but it is still not confirmed. Despite that the application of N-acetyl cysteine to prevent CI-AKI is controversial, N-acetyl cysteine remains a commonly utilized agent even without solid scientific evidence. The application of statins for the prevention of CI-AKI after intravascular contrast medium administration revealed some promising results but it is still premature to implement their application in daily clinical practice. Therefore, there is a need for additional well designed and sufficiently powered randomized controlled trials to clarify these issues and to assess the risk vs benefit of all other methods for the purpose of CI-AKI prevention.Background: The risk of contrast-induced acute kidney injury (CI-AKI) has been accepted lately by medical literature and practice since it is the third leading cause of acute kidney injury in hospitalized patients. Different measures in practice are being used to prevent the incidence of CI-AKI. Objective: In this review, we aimed to discuss the different methods of prevention of CI-AKI mentioned in the literature. Methods: A comprehensive search was done using biomedical databases including Medline, and PubMed, for studies concerned with the assessment of Contrast-Induced Acute Kidney Injury. Keywords used in our search through the databases were “Contrast-Induced Kidney Failure” and “Diagnosis & Management”. Conclusion: Intravenous (IV) fluid hydration is the mainstay of practice in the prevention of CI-AKI. Intravenous administration of sodium bicarbonate has also gained notable importance in the prevention of CI-AKI, but it is still not confirmed. Despite that the application of N-acetyl cysteine to prevent CI-AKI is controversial, N-acetyl cysteine remains a commonly utilized agent even without solid scientific evidence. The application of statins for the prevention of CI-AKI after intravascular contrast medium administration revealed some promising results but it is still premature to implement their application in daily clinical practice. Therefore, there is a need for additional well designed and sufficiently powered randomized controlled trials to clarify these issues and to assess the risk vs benefit of all other methods for the purpose of CI-AKI prevention.