Use of contrast material during angiographic procedures may lead to acute renal insufficiency, and even death. The authors describe the contrast-induced nephrotoxic effects, at-risk patients, and measures to prevent the occurrence of these effects. Indications, actions, and adverse effects of acetylcysteine and fenoldopam are also discussed.

With the aging of the population, the number of diagnostic and interventional procedures in cardiac catheterization laboratories and radiology departments has steadily increased.11 Use of contrast material during angiographic procedures may lead to acute renal insufficiency, prolonged hospital stays, and even death.22–,44 Strategies to prevent the effects of contrast nephrotoxicity have met with limited or no success. These strategies include the use of theophylline, furosemide, mannitol, low-dose dopamine, adenosine, calcium antagonists, atrial natriuretic peptide, and inhibitors of oxygen-free radicals.55–,1111 

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