How Can We Reduce the Incidence of Contrast-Induced Acute Renal Failure?
| to pdf >> By Baudelio Herrada, MD; Jay Agarwal, MD; Antoine C Abcar, MD Report of a Case A 60-year-old female with history of diabetes mellitus type II, hypertension, coronary artery disease, and chronic kidney disease (baseline serum creatinine level 1.5 mg/dL, and GFR 38 mL/min) was admitted to the hospital with a non-ST elevation myocardial infarction. In preparation for cardiac catheterization, the patient received N-acetylcysteine (Mucomyst). She then underwent catheterization with the placement of two stents. The next day, the patient had decreased urine output (900 mL/day). From a baseline level of 1.5 mg/dL, measured on the first hospital day, the creatinine level increased on subsequent hospital days to 2.0 mg/dL, 3.3 mg/dL, 3.8 mg/dL, and 4.9 mg/dL, respectively. Neither the patient’s medical history nor review of her medical chart showed any evidence of periprocedural hypotension or use of nephrotoxic medication. Thus, this rapid onset of acute renal failure after cardiac
