Review
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Radiol. Jun 28, 2024; 16(6): 168-183
Published online Jun 28, 2024. doi: 10.4329/wjr.v16.i6.168
Navigating nephrotoxic waters: A comprehensive overview of contrast-induced acute kidney injury prevention
Panagiotis Theofilis, Rigas Kalaitzidis
Panagiotis Theofilis, Rigas Kalaitzidis, Center for Nephrology "G Papadakis", General Hospital of Nikaia-Piraeus "Agios Panteleimon", Nikaia-Piraeus 18454, Greece
Author contributions: Theofilis P performed the literature review and drafted the original manuscript; Kalaitzidis R supervised the study and performed revisions on the original draft.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: Https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Panagiotis Theofilis, MD, PhD, Doctor, Researcher, Center for Nephrology "G Papadakis", General Hospital of Nikaia-Piraeus "Agios Panteleimon", Mantouvalou 3, Nikaia-Piraeus 18454, Greece. panos.theofilis@hotmail.com
Received: April 27, 2024
Revised: May 19, 2024
Accepted: June 17, 2024
Published online: June 28, 2024
Processing time: 59 Days and 20 Hours
Abstract

Contrast-induced acute kidney injury (CI-AKI) is the third leading cause of acute kidney injury deriving from the intravascular administration of contrast media in diagnostic and therapeutic procedures and leading to longer in-hospital stay and increased short and long-term mortality. Its pathophysiology, although not well-established, revolves around medullary hypoxia paired with the direct toxicity of the substance to the kidney. Critically ill patients, as well as those with pre-existing renal disease and cardiovascular comorbidities, are more susceptible to CI-AKI. Despite the continuous research in the field of CI-AKI prevention, clinical practice is based mostly on periprocedural hydration. In this review, all the investigated methods of prevention are presented, with an emphasis on the latest evidence regarding the potential of RenalGuard and contrast removal systems for CI-AKI prevention in high-risk individuals.

Keywords: Contrast-induced acute kidney injury; Contrast media; Prevention; Hydration; RenalGuard; Dyevert

Core Tip: Although periprocedural hydration is a fundamental preventive measure for contrast-induced acute kidney injury (CI-AKI), recent research suggests exploring emerging strategies such as RenalGuard and contrast removal systems. These innovative approaches show promise, particularly in high-risk individuals with critical illness or pre-existing renal and cardiovascular conditions. By staying updated on the latest evidence and incorporating these advancements into clinical practice, healthcare professionals can enhance CI-AKI prevention efforts and improve patient outcomes.