ABSTRACT
The mechanisms by which contrast agents induce acute renal failure are complex and not well understood.The main factors are osmotic, toxic, and hemodynamic.1Therefore, the optimal strategy to prevent contrast-induced nephrotoxicity remains uncertain.At present, recommendations are:
• Periprocedural hydration2
• Use of a low-or iso-osmolality contrast3-6 and • Limitation of the amount of contrast agent used7-10
A number of pharmacologic approaches to prevent contrast nephrotoxicity have been suggested. However, most of these strategies proved to be ineffective or harmful (Table 9.1). Recently, considerable interest has resulted from the preliminary positive data on the effectiveness of prophylactic administration of antioxidant compounds11 and fenoldopam.12
