[What is reliable in prevention of contrast medium-induced nephropathy?].

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 radiocontrast 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 hydration is the most relevant and significant measure for prevention of radiocontrast 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 administration of radiocontrast should be supplied. Hemodialysis is recommended if impaired renal function (serum creatinine > 3.5 mg/dl) is accompanied by additional risk factors, e.g. diabetes mellitus. The impact of dialysis therapy is not clarified by clinical studies.