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SCAI issues recommendations to prevent kidney damage after imaging procedures

  • Make sure patients are adequately hydrated before, during, and after the procedure. -- "Hydration is very important in preventing CIN," Dr. Schweiger said. "High-risk patients should come for their procedure in plenty of time to be properly hydrated using intravenous hydration."
  • Address with patients whether to discontinue the use of non-steroidal anti-inflammatory (NSAID) agents 2448 hours before a procedure. -- Medications such as ibuprofen and Naprosyn are known as NSAIDs and are usually taken for aches and pains associated with arthritis, headache, back injury, and other ailments. These medications can potentially cause a kidney problem by decreasing blood flow to the kidneys. Because contrast dyes can also decrease kidney blood flow, the two agents should not be given concurrently.
  • In patients at increased risk for CIN, use contrast agents with lower osmolarity, and in the smallest possible quantities. -- Contrast agents with lower osmolarity are less dense and, therefore, less likely to interfere with blood flow to the kidneys.
  • Monitor patients at increased risk for CIN very closely for up to 48 hours after a procedure that involved the use of contrast dye. -- Physicians and nurses should be on the lookout for any signs of kidney failure. During this period, the serum creatinine test is useful for monitoring kidney function. In addition, patients should not resume taking NSAIDs until their kidney function has returned to normal.

    CIN is a rare complication and, in most cases, is preventable, Dr. Schweiger stressed. "We certainly do not want to discourage people from having a procedure they really need because of fears of a complication that is unlikely to occur. The benefits of undergoing most diagnostic and interventional procedures far outweigh any risks associated with the use of contrast dye in such procedures," he said. "In fact, contrast dyes have helped us make enormous progress in the treatment of p
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  • Contact: Wayne Powell
    wpowell@scai.org
    703-772-7910
    Society for Cardiovascular Angiography and Interventions
    11-Dec-2006


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