Haemodialysis for the Prevention of Contrast-Induced Nephropathy: Outcome of 31 Patients With Severely Impaired Renal Function, Comparison With Patients at Similar Risk and Review

Huber W, Jeschke B, Kreymann B, et al. Haemodialysis for the prevention of contrast-induced nephropathy. Outcome of 31 patients with severely impaired renal function, comparison with patients at similar risk and review. Invest Radiol 2002;37:471–481. RATIONALE AND OBJECTIVES.To investigate whether haemodialysis prevents contrast-induced nephropathy (definitionincrease of serum-creatinine of ≥ 0.5 mg/dL within 7 days). MATERIALS AND METHODS.Thirty-one patients (mean serum-creatinine 4.01 ± 1.83 mg/dL) were dialyzed for 4.36 ± 1.0 hours within one hour after 278.4 ± 160.5 mL of contrast medium. RESULTS.Dialysis resulted in a significant reduction of serum-creatinine (2.25 ± 1.46 mg/dL;P < 0.0001) and stable mean serum-creatinine levels 2, 3, 4, and 7 days after contrast medium and at discharge compared with baseline values. However, 19 patients (61%) developed contrast-induced nephropathy within 7 days. Four patients had to be repeatedly dialyzed. A comparison of our patients’ 48 hours-incidence of contrast-induced nephropathy (9/31; 29%) versus patients at comparable risk included in seven previous studies demonstrated a prophylactic effect of dialysis only versus a subgroup in one study. CONCLUSIONS.Data provide no hint that haemodialysis prevents contrast-induced nephropathy. Therefore, postprocedural dialysis should be restricted to patients participating in clinical studies.