How Can Contrast Agent induced Nephropathy Be Prevented?
First, nephropathy is not really a worry in patients with truly normal renal function, regardless of the volume of contrast agent injected. For patients at risk, the first step in preventing nephropathy is adequate hydration (18). In practical terms, adequate hydration is usually achieved by instructing patients to drink several liters of fluid over 12 24 hours before contrast agent injection. When such hydration isn t possible because an imaging study is urgent, because the patient cannot take oral fluids, or because sedation or anesthesia will be needed and thus oral fluids are contraindicated, intravenous hydration can be given and may actually be more effective. Intravenous hydration should consist of at least 1 mL of normal saline per kilogram of body weight per hour, beginning 12 hours before contrast agent injection and continuing for 12 hours afterward. It is also important to remember that, invariably, patients do not adequately hydrate themselves; thus, for patients at risk o
