PREVENTION OF RADIOCONTRAST NEPHROPATHY - WHAT ARE THE FACTS

Nephropathy is one of the most important side effects of radiocontrast in patients with impaired renal function. Incidence is reported from 20% to 100%, depending on underlying disease. For prevention of radioc ontrast nephropathy a large number of substances were investigated in experimental and clinical studies. Clinical relevance of this findings will be assessed by this article. In summary of these studies hydrati on is the most relevant and significant measure for prevention of radi ocontrast nephropathy in patients at risk (i.e. serum creatinine > 1,5 mg/dl). 1 ml/kg body weight/h with 0,45% NaCl 12 h before and after a dministration of radiocontrast should be supplied. Hemodialysis is rec ommended if impaired renal function (serum creatinine > 3,5 mg/dl) is accompanied by additional risk factors, e.g. diabetes mellitus. The im pact of dialysis therapy is not clarified by clinical studies.