Contrast induced nephrotoxicity

Question 1

What is contrast induced nephrotoxicity?

Answer 1

25% increase in creatinine occurring within 3 days of the intravascular administration of contrast media

Question 2

What are the main risk factors for contrast induced nephrotoxicity?

Answer 2

known renal impairment (especially diabetic nephropathy)
age > 70 years
dehydration
cardiac failure
the use of nephrotoxic drugs such as NSAIDs

Question 3

What proceedures can result in contrast induced nephrotoxicty?

Answer 3

CT with contrast
coronary angiography/percutaneous coronary intervention (PCI)

Question 4

How can contrast induced nephrotoxicity be prevented?

Answer 4

Intravenous 0.9% sodium chloride at a rate of 1 mL/kg/hour for 12 hours pre- and post- procedure

Question 5

When should the intravenous sodium chloride be administered?

Answer 5

12 hours pre and post proceedure

Question 6

What should patients who are high-risk for contrast-induced nephropathy have withheld?

Answer 6

Metformin for a minimum of 48 hours and until the renal function has been shown to be normal

Question 7

For how long should metformin be withheld?

Answer 7

For a minimum of 48 hours and until the renal function has been shown to be normal.