Prophylaxis of Contrast-Induced Nephropathy in Intravascular Contrast Computed Tomography Procedures by Use of Low Osmolality Contrast Media and Good Hydration

Consequent to the extended use of intravenous iodinated contrast media, increased adverse effects have been recognized, with Contrast-Induced Nephropathy (CIN) constituting one of the most serious of these adverse effects. The purpose of the current study was to investigate a prophylaxis strategy for reducing the effect of intravenous contrast on the development of CIN. Data were collected from 120 patients who received intravenous iodinated contrast agents during CT procedures. CIN was defined as a relative increase of more than 25% or an absolute increase of ≥ 0.5 mg/dL (44 µmol/L) in serum creatinine levels within 48-72 hours post-CT. Our prophylaxis strategy involved intravenous administration of 500 ml normal saline within one hour before the CT procedure and 3 liters of oral hydration within 12 hours post-CT. Additionally, the volume of administered low osmolality contrast media was based on the weight of the patient. A paired t-test revealed no statistically significant differences in creatinine (t = 0.07, P = 0.942) or urea (t = 0.52, P = 0.608) pre-CT vs. post intravenous iodinated contrast media-enhanced CT. Use of low osmolality contrast media and good hydration pre and post intravenous iodinated contrast administration are effective approaches to the prevention of CIN.