Pharmacotherapeutic options to prevent radiocontrast-induced acute renal failure

One of the primary etiologies of acute renal failure (ARF) is nephropathy secondary to the administration of radiocontrast dye. In the United States alone, the cost of ARF-related expenses is estimated at more than $8 billion per year. Since ARF contributes such a substantial burden to the cost of healthcare and may be associated with significant morbidity and mortality, initiatives to educate pharmacists, physicians, and other health-care providers about how to decrease the incidence of radiocontrast-induced ARF are warranted. It is important to identify patients at risk for developing this pathology and to play an active role in disease state prevention. This review covers the pathogenesis, signs and symptoms, and current treatment options for reducing the risk of radiocontrast-induced nephropathy. Current pharmacotherapy focuses on the use of aggressive hydration before and after the administration of a contrast agent. Clinical trials evaluating the application of periprocedural drugs are also reviewed.