Radiographic contrast material-induced nephropathy (RCIN) is the third most common cause of hospital-acquired renal insufficiency and has been associated with an increase in patient mortality. Many strategies to prevent RCIN have been explored unsuccessfully. The standard of care remains hydration with 0.45% sodium chloride before and after administration of contrast material. Recently, N-acetylcysteine and fenoldopam have been studied to determine their efficacy in preventing RCIN. Of seven prospective studies using various dosing regimens of N-acetylcysteine, four revealed beneficial results. Although some discrepancies exist, the data strongly suggest that N-acetylcysteine has a role in patients at risk for the development of RCIN. The data for fenoldopam are more limited, with only one retrospective study showing benefit. Additional prospective data are required to determine if fenoldopam has a role in the prevention of RCIN.

Anemia is the most frequently encountered hematologic complication in human immunodeficiency virus (HIV) infection and acquired immunodeficiency syndrome. The prevalence estimates vary widely with the severity of HIV disease. Data suggest that treatment with highly active antiretroviral therapy may have a positive impact on reducing the prevalence of anemia of chronic disease in patients infected with HIV. Anemia consistently has been shown to be a predictor of decreased survival, and treatment plays an important role in improving patients' survival and quality of life (e.g., fatigue and dementia). Addressing potential underlying reversible causes and treating the chronic anemia are important strategies in the management of anemia. Erythropoietin therapy should be considered a first-line treatment, and blood transfusions should be limited to situations requiring immediate correction of hemoglobin levels.