Contrast-Induced AKI

• Define and stage AKI after administration of intravascular contrast media as per Recommendations AKI Definition. (Not Graded)
  • In individuals who develop changes in kidney function after administration of intravascular contrast media, evaluate for CI-AKI as well as for other possible causes of AKI. (Not Graded)
• Assess the risk for CI-AKI and, in particular, screen for pre-existing impairment of kidney function in all patients who are considered for a procedure that requires intravascular administration of iodinated contrast medium. (Not Graded)
• Consider alternative imaging methods in patients at increased risk for CI-AKI. (Not Graded)
• Use the lowest possible dose of contrast medium in patients at risk for CI-AKI. (Not Graded)
• We recommend using either iso-osmolar or lowosmolar iodinated contrast media, rather than highosmolar iodinated contrast media in patients at increased risk of CI-AKI. (1B)
• We recommend i.v. volume expansion with either isotonic sodium chloride or sodium bicarbonate solutions, rather than no i.v. volume expansion, in patients at increased risk for CI-AKI. (1A)
• We recommend not using oral fluids alone in patients at increased risk of CI-AKI. (1C)
• We suggest using oral NAC, together with i.v. isotonic crystalloids, in patients at increased risk of CI-AKI. (2D)
• We suggest not using theophylline to prevent CI-AKI. (2C)
• We recommend not using fenoldopam to prevent CIAKI. (1B)
• We suggest not using prophylactic intermittent hemodialysis (IHD) or hemofiltration (HF) for contrastmedia removal in patients at increased risk for CIAKI. (2C)

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Van Rensburg B, Naicker S, Paget G, et al. Guideline for the Care of Patients with Acute Kidney Injury. South African Renal Society (Adopted KDIGO Guideline); 2015.