Risk Factors for and Methods to Prevent Contrast-Induced Nephrotoxicity

Risk factorMethod
Advanced age, antibiotics (aminoglycosides such as gentamycin), cardiovascular disease, chemotherapy, collagen vascular diseases, elevated serum creatinine levels (variable levels, 1.3–2.0 mg/dL), dehydration, diabetes (insulin-dependent > 2 y; non–insulin-dependent > 5 y), nonsteroidal antiinflammatory medications, paraproteinemias (myeloma), renal disease, kidney transplantUse the smallest amount of contrast material possible; discontinue other nephrotoxic medications before the procedure; maintain adequate interval between procedures requiring contrast material; maintain hydration (oral, 500 mL before the procedure and 2,500 mL during the 24 h after the procedure; intravenous, 0.9% or 0.45% saline, 100 mL/h, beginning 4 h before the procedure and continuing for the 24 h after the procedure)