Prophylaxis for Acute Kidney Injury

Prevention of Acute Kidney Injury

1. acetylcysteine 1,2000m g PO on day before and on the day of administration of the contrast agent, x 2 days PLUS
2. saline 0.45% IV at 1ml/KgBW/h x12h before and 12h after administration of contrast agent
3. for EMERGENCY procedures:  154 mEq/L NaHCO3 bolus of 3 ml/Kg/h x 1h before iopamidol contrast ffd by infusion of 1 ml/Kg/h x6h after procedure
4. reduce contrast load

 

General Measures:

1. maintain adequate BP
2. optimize fluid balance
3. adjust med dosage to renal function
4. avoid NSAIDs

 

Reference:

Layon, A. Joseph, Andrea Gabrielli, and William A Friedman. Textbook Of Neurointensive Care. Print.