Contrast induced acute kidney injury

Abstract

Background. CI-AKI remains as one of the most confusing conditions in medical imaging practice, covering urgent diagnosis; hence immediate intervention to avoid its negative outcomes. Objective of study. In this respect, a review and summary of strategies for the assessment and management of CI-AKI with accent on brand new developments in pathophysiology, risk stratification and diagnostic, and therapeutic approaches has been made here. Material and methods. An extensive literature review was undertaken covering the most recent studies; clinical guidelines have been included also. This included pertinent peer-review articles, clinical trial and meta-analysis about pathophysiology of CI-AKI, risk factors, diagnosis, and therapeutic management. Results. The article indicated multi-faceted approaches for the management of CI-AKI as follows: (1) Risk Stratification - it highlighted predictive models and biomarkers to identify high-risk patients; (2) Preventive Measures – pre-procedure and peri-procedure hydration with isotonic saline or sodium bicarbonate; (3) Pharmacological Interventions - agents like N-acetylcysteine, statins, and ascorbic acid in use during CI-AKI and new drugs for which emerging evidence exists; (4) Advanced Diagnostics; (5) Early detection - new biomarkers and advanced imaging techniques for sensitivity and specificity; (6) Timely Intervention; (7) Continuous monitoring of renal function post-contrast exposure and immediate therapeutic action. Conclusions. Treatment of CI-AKI requires a multi-dimensional approach with identifying a thorough risk profile, appropriate preventive strategies, and a watchful eye on monitoring. Nevertheless, advanced diagnostics and, on that basis, high individual risk profile-based treatment regimens represent determinant factors in the reduction of incidence of CI-AKI for better patient outcomes.