The prevention of contrast-induced nephropathy by simultaneous hemofiltration during coronary angiographic procedures: A comparison with periprocedural hemofiltration

Contrast-induced nephropathy following angiography and cardiac interventions

“…In order to minimise CM load, novel automated contrast injection devices have been developed which decrease the volume of CM used and which have been shown to reduce the incidence of CIN. 84 It has been proposed that rapid removal of CM from the blood pool may have benefit in preventing CIN; although prophylactic HD has not been shown attenuate the incidence of CIN, 85 some benefit has been observed with both pre-procedural and post-procedural 86 haemofiltration (HF) and simultaneous HF, 87 which may be partially explained through optimisation of periprocedural intravascular volumes. However, HF is a resource-intensive therapy that should be reserved for very-high-risk patients, such as for those with pre-dialysis ESRF 88 or those with severe CKD undergoing complex PCI.…”

Comparison of Two Risk Models in Predicting the Incidence of Contrast‐Induced Nephropathy after Percutaneous Coronary Intervention

“…Other therapies such as hemofiltration, allopurinol, citrate, magnesium sulfate, ascorbic acid, theophylline, and dopamine-1-agonists have also been studied, but results were inconsistent or had only small benefit. [23][24][25][26][27][28] Regarding different CIN definitions in prior studies, the Mehran's is more universally accepted, and we consider it more appropriate. Skelding et al 29 found that a creatinine raise of 0.5 mg/dl or more had a better sensitivity predicting mortality as compared to an increase of 1.0 mg/dl, with a slight decrease in the discriminatory power.…”

“…The RenalGuard system seems to have benefit over sodium bicarbonate and N‐acetylcysteine, but further randomized studies are needed to confirm its efficacy. Other therapies such as hemofiltration, allopurinol, citrate, magnesium sulfate, ascorbic acid, theophylline, and dopamine‐1‐agonists have also been studied, but results were inconsistent or had only small benefit …”

Contrast-induced Acute Kidney Injury: A Contemporary Review

“…Patients already under hemodialysis do not require volume support before a contrast study, and dialysis after the procedure is necessary only with frank liquid overload. As to hemofiltration, benefits in high-risk cohorts were not confirmed, despite some authors' successful use in very high-risk patients with Stage 5 CKD before and after the radiographic contrast study [19,21,85,86].…”

“…However, clinical practice and most studies on CI nephropathy prefer the first definition as a simpler one with superior correlation with clinical outcomes [1,7,[16][17][18][19][20][21].…”