What is the recommended hydration protocol to prevent nephrotoxicity from contrast media?

The recommended hydration protocol to prevent nephrotoxicity from contrast media involves administering intravenous fluids before and after the procedure. This approach is crucial for maintaining kidney function and reducing the risk of contrast-induced nephropathy, especially in patients at higher risk, such as those with pre-existing kidney impairment or diabetes.

By providing intravenous fluids, hydration is rapidly achieved, ensuring that the kidneys are adequately perfused and can efficiently excrete the contrast agent. The fluids help to dilute the concentration of the contrast media within the renal tubules and promote urine flow, which further aids in the elimination of the contrast from the body. Administering fluids before the procedure helps to preload the kidneys, while post-procedure hydration continues to facilitate the clearance of any residual contrast.

In contrast, limiting fluid intake before the procedure can exacerbate the risk of nephrotoxicity, as it can lead to dehydration. Providing only oral hydration may not be sufficient or timely enough to protect the kidneys in high-risk patients, particularly during procedures where rapid changes in kidney perfusion may occur. Using diuretics prior to the procedure is generally not recommended for preventing nephrotoxicity, as it can lead to increased urine output and potentially worsen dehydration, counteracting any benefits from the diuretics