How do you reduce contrast-induced acute kidney injury?

How do you reduce contrast-induced acute kidney injury?

Adequate hydration before the procedure (such as that based on the targeted hydration trials) would still be a key to reduce the risk of CI-AKI. Use of short-term high-intensity statins is supported by this network meta-analysis and by the guidelines; however, more data are needed in patients with CKD stage 3 or worse.

Which agent will best reduce the risk of contrast nephropathy?

For patients at an increased risk for CIN who are receiving intra-arterial contrast, nonionic iso-osmolar agents (iodixanol) are associated with the lowest risk of CIN.

Can you give statins with AKI?

Statins. Statins do not accumulate in renal impairment, are not associated with acute kidney injury following cardiac surgery (80, 81) and may reduce the risk of contrast induced AKI (82, 83).

Can Atorvastatin cause acute kidney injury?

[13] Among all the participants, AKI occurred in 20.8% in the atorvastatin and in 19.5% in the placebo group. However, statin-naive subjects, and particularly those with underlying chronic kidney disease, developed more AKI.

What medications are contraindicated with contrast dye?

In patients with cardiovascular disease, kidney disease, and/or diabetes, renin-angiotensin system blockers, non-steroidal anti-inflammatory drugs, diuretics, and metformin can increase the risk of CI-AKI when undergoing contrast imaging.

What GFR is safe for IV contrast?

If eGFR value is greater than 30 the patient can receive IV iodinated contrast. If eGFR is less than or equal to 30 the case will need approval by the radiologist before IV contrast is used to minimize risk of contrast related AKI.

Which of the following medications should be held if a resident is receiving contrast dye for a procedure?

To avoid this complication, metformin must be withheld after the administration of the contrast agent for 48 hours, during which the contrast-induced renal failure becomes clinically apparent. If renal function is normal at 48 hours, the metformin can be restarted.

What medications should be stopped before CT with contrast?

for CT Studies with IV Radiographic Contrast Media Metformin medications should be stopped at the time of or prior to CT studies with IV Contrast, AND withheld for 48 hours after the procedure.

Does atorvastatin affect kidney function?

In conclusion, our analysis shows that atorvastatin improves kidney function over time in a dose‐dependent manner (ie, 80‐mg versus 10‐mg dose). In each of the treatment groups it was shown that kidney function improvement is strongly associated with lower cardiovascular risk.

What drugs should be stopped in AKI?

Clinicians managing patients with AKI therefore frequently stop drugs that lower blood pressure (particularly ACEI and ARBs, which selectively reduce glomerular pressure) and diuretics. ACEIs, ARBs and potassium-sparing diuretics may also be stopped because of hyperkalaemia.

Which of the following medications should be held if receiving contrast dye?

What two medications are commonly used to pre medicate a patient with a history of contrast allergy?

The current standard of care in the United States is to pre-medicate patients with steroids and diphenhydramine to decrease risk of repeat contrast reaction in patients who have had a reaction in the past to a similar class contrast agent if it was moderate or severe (see table below).