University of Maryland School of Medicine

Department of Emergency Medicine

University of Maryland School of Medicine Department of Emergency Medicine

UMEM Educational Pearls

Category: Toxicology

Title: Prevention of Contrast-Induced Nephropathy

Keywords: atorvastatin, acetylcysteine (PubMed Search)

Posted: 1/31/2013 by Fermin Barrueto, MD (Updated: 4/17/2014)
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There have been many attempts to reduce the incidence of contrast-induced nephropathy. Mechanism usually centers around antioxidant properties or free radical scavengers that prevent the acute kidney injury that may result after intravenous contrast. IV Fluid hydration, sodium bicarbonate and acetycysteine have been studied with only some evidence. There is also some controversial data that is beginning to surface regarding the use of atorvastatin with a recent article in Circulation 2012 that showed high dose atorvastatin (80mg) 24 hrs prior to angiography prevented contrast-induced acute kidney injury in patients with mild to medium risk. Link to article has been provided:

http://circ.ahajournals.org/content/126/25/3008