Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • News & Views
  • Published:

Acute kidney injury

Intravenous hydration for the prevention of CIAKI

Iodinated contrast media are essential for diagnostic and interventional radiological and cardiological procedures, but may cause kidney damage. Intravenous hydration is the current cornerstone for prevention of contrast-induced acute kidney injury; however, new data from the AMACING trial suggest that this approach might not be beneficial in low-risk patients.

This is a preview of subscription content, access via your institution

Access options

Buy this article

Prices may be subject to local taxes which are calculated during checkout

Figure 1: Proposed hydration strategy for the prevention of contrast-induced acute kidney injury (CIAKI).

References

  1. Windecker, S. et al. 2014 ESC/EACTS Guidelines on myocardial revascularization: the task force on myocardial revascularization of the European Society of Cardiology (ESC) and the European Association for Cardio-Thoracic Surgery (EACTS). Developed with the special contribution of the European Association of Percutaneous Cardiovascular Interventions (EAPCI). Eur. Heart J. 35, 2541–2619 (2014).

    Article  Google Scholar 

  2. Lameire, N., Kellum, J. A. & KDIGO AKI Guideline Work Group. Contrast-induced acute kidney injury and renal support for acute kidney injury: a KDIGO summary (part 2). Crit. Care 17, 205 (2013).

    Article  Google Scholar 

  3. Nijssen, E. C. et al. Prophylactic hydration to protect renal function from intravascular iodinated contrast material in patients at high risk of contrast-induced nephropathy (AMACING): a prospective, randomised, phase 3, controlled, open-label, non-inferiority trial. Lancet http://dx.doi.org/10.1016/S0140-6736(17)30057-0 (2017).

  4. Liu, Y. et al. Excessively high hydration volume may not be associated with decreased risk of contrast-induced acute kidney injury after percutaneous coronary intervention in patients with renal insufficiency. J. Am. Heart Assoc. 5, e003171 (2016).

    PubMed  PubMed Central  Google Scholar 

  5. McDonald, R. J. et al. Intravenous contrast material exposure is not an independent risk factor for dialysis or mortality. Radiology 273, 714–725 (2014).

    Article  Google Scholar 

  6. Gurm, H. S. et al. Renal function-based contrast dosing to define safe limits of radiographic contrast media in patients undergoing percutaneous coronary interventions. J. Am. Coll. Cardiol. 58, 907–914 (2011).

    Article  Google Scholar 

  7. Briguori, C. et al. Renal Insufficiency After Contrast Media Administration Trial II (REMEDIAL II): RenalGuard System in high-risk patients for contrast-induced acute kidney injury. Circulation 124, 1260–1269 (2011).

    Article  CAS  Google Scholar 

  8. Brar, S. S. et al. Haemodynamic-guided fluid administration for the prevention of contrast-induced acute kidney injury: the POSEIDON randomised controlled trial. Lancet 383, 1814–1823 (2014).

    Article  Google Scholar 

  9. Mehran, R. et al. A simple risk score for prediction of contrast-induced nephropathy after percutaneous coronary intervention: development and initial validation. J. Am. Coll. Cardiol. 44, 1393–1399 (2004).

    PubMed  Google Scholar 

  10. Gurm, H. S., Seth, M., Kooiman, J. & Share, D. A novel tool for reliable and accurate prediction of renal complications in patients undergoing percutaneous coronary intervention. J. Am. Coll. Cardiol. 61, 2242–2248 (2013).

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Carlo Briguori.

Ethics declarations

Competing interests

The authors declare no competing financial interests.

PowerPoint slides

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Briguori, C., Signoriello, G. Intravenous hydration for the prevention of CIAKI. Nat Rev Nephrol 13, 264–266 (2017). https://doi.org/10.1038/nrneph.2017.41

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/nrneph.2017.41

This article is cited by

Search

Quick links

Nature Briefing

Sign up for the Nature Briefing newsletter — what matters in science, free to your inbox daily.

Get the most important science stories of the day, free in your inbox. Sign up for Nature Briefing