Thursday, September 17, 2015

Topic update: contrast induced AKI


Here is a freefull text review in the journal Cardiorenal Medicine.

Of note:

Volume expansion with saline or bicarb based fluid is recommended for prevention of AKI in high risk patients. Evidence suggests bicarb is superior but the review comes short of recommending one fluid over another.

Evidence is cited in favor of volume expansion and forced diuresis, but the review makes no firm recommendations pending further trials.

Given the mixed results with N-acetylcysteine its use is now considered controversial and no recommendation was given.

Evidence favoring a protective effect of ascorbic acid was cited but no recommendation made.

Evidence favoring a protective effect of statins was cited but no recommendation made.

Conspicuously absent from the review was mention of remote ischemic preconditioning which has shown great promise in recent studies.


No comments: