Contrast-induced acute kidney injury: the at-risk patient and protective measures.

Contrast-induced acute kidney injury (CI-AKI) is a major complication following radiocontrast procedures. In this review, we characterize the recent literature on CI-AKI, risk factors, prevention, biomarkers, and new technologies. The premise of CI-AKI prophylaxis should focus on implementing mandatory standing orders before and after cardiac catheterization for hydration with normal saline or sodium bicarbonate and use of high-dose (1200-mg) N-acetylcysteine. Contrast agents may play a role in preventing CI-AKI. Implement catheter-laboratory technology and awareness to limit the amount of contrast dye used for any patient.