Prevention of contrast induced nephropathy in cardiac cath patients
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- Answered 22 Sep 2019 Conflict of interest declaration: None prevention of contrast induced nephropathy in cardiac cath patients In 2016 the AHRQ published Contrast-Induced Nephropathy: Comparative Effectiveness of Preventive Measures . The full-text is freely available via the link below, but it concluded: “The evidence shows a clinically important and statistically significant benefit in studies of three comparisons: low-dose N-acetylcysteine compared with IV saline, N-acetylcysteine compared with IV saline in patients receiving LOCM, and statins plus N-acetylcysteine compared with N-acetylcysteine alone in patients receiving intra-arterial contrast media. Future research is needed to determine whether statins can reduce CIN in patients receiving IV contrast media, and to further define specific contexts in which patients could benefit from use of N-acetylcysteine.” This was the highest quality, recent, review I could find. A 2017 paper  suggested “Identifying patients at risk is an important step in preventing CIN.” Finally, Heart, published an “Education in Heart” article that you might find interesting  References 1) https://effectivehealthcare.ahrq.gov/sites/default/files/related_files/nephropathy-contrast-induced-prevention-report-160407.pdf 2) https://www.ncbi.nlm.nih.gov/pubmed/29173356 3) https://heart.bmj.com/content/102/8/638