Prevention and treatment of contrast-associated nephropathy in interventional cardiology.

Contrast-induced nephropathy (CIN) is a common complication after diagnostic and therapeutic cardiovascular procedures that is associated with significant mortality and morbidity. CIN is highly prevalent in patients with well-known risk factors, including older age, chronic renal insufficiency, congestive heart failure, and diabetes. Thus far, no strategies have been shown to be effective in preventing CIN beyond thorough patient selection, minimizing the amount of contrast agent, and meticulous hydration of the patient. The role of various drugs in preventing CIN is still controversial and warrants future studies. Despite the remaining uncertainty regarding the degree of nephrotoxicity produced by various contrast agents, nonionic low-osmolar contrast media may be preferred in patients at high risk for CIN.