How is contrast-induced nephropathy (CIN) prevented in patients with chronic heart failure (CHF)?

Updated: Feb 21, 2020
  • Author: Anita Basu, MD, FACP; Chief Editor: Vecihi Batuman, MD, FASN  more...
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Chronic heart failure (CHF) poses a particular challenge. Patients with compensated CHF should still be given volume, albeit at lower rates. Patients with uncompensated CHF should undergo hemodynamic monitoring, if possible, and diuretics should be continued. In emergency situations, clinical judgment should be used and, in the absence of any baseline renal function, adequate postprocedure hydration should be carried out.

In patients with CHF and chronic kidney disease who were undergoing coronary procedures, Qian et al found that CIN occurred less often in patients who received hydration plus nitrates than in those who received routine hydration (12.8% vs. 21.2%; P=0.018). The treatment group received continuous intravenous infusion of isosorbide dinitrate combined with intravenous infusion of isotonic saline at a rate of 1.5 ml/kg/h. [40]

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