Protection rénale et administration de produits de contraste

The incidence of radiocontrast-associated renal dysfunction is increasing due to a more frequent use of diagnostic and therapeutic imaging inpatients with associated co-morbidities such as diabetes, chronic cardiac and renal failure. Contrast material-induced nephropathy could be prevented by hydratation, the use of moderately hyperosmolar contrast media and limitation of the amount of material administered and avoidance of other nephrotoxic agents. Isotonic bicarbonate solutions associated with a large infusion and high doses of N-acetylcysteine may be useful. In patients with preexisting chronic renal insufficiency hemofiltration could be indicated before and after the administration of radio contrast media.