What is the most effective way to reduce the risk of contrast-induced nephropathy?

Hydration before and after a procedure is widely recognized as a highly effective method for reducing the risk of contrast-induced nephropathy. The primary mechanism is that adequate hydration helps to maintain renal perfusion and dilute the concentration of contrast material within the renal tubules. This dilution can mitigate the nephrotoxic effects of contrast media, facilitating its clearance from the body and protecting kidney function.

In many clinical protocols, the administration of isotonic saline or other fluid therapies is routinely employed to ensure sufficient hydration before and after angiographic procedures or CT scans that utilize contrast agents. Studies have consistently shown that proper hydration decreases the incidence of contrast-induced nephropathy in high-risk patients, such as those with pre-existing renal impairment or diabetes.

While the other methods listed may have some benefit, none have shown the same level of efficacy as hydration in preventing contrast-induced nephropathy. Using a lower contrast volume may help but does not directly address the effects on renal perfusion as effectively as hydration does. Administering N-acetylcysteine has been proposed as a preventive measure, but its effectiveness has shown mixed results and is not as universally supported as hydration. Performing an ultrasound may assist in diagnosing kidney issues but does not contribute to risk reduction regarding contrast exposure