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Discussion

When do you hydrate the pt

Settle a bet guys,how high is the creatinine when you pre hydrate the pt.Thanks:monkeydance:

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  • Admin

ALL pts who will receive IV contrast should be prehydrated, in order to PREVENT any CIN (Contrast-induced nephropathy).

Check out the articles below (obtained by doing a Google search using the words "contrast prehydration prevent nephropathy"):

http://www.apia.org.au/pdf/May06_ContrastInducedNephropathy.pdf

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=16360994&dopt=Abstract

http://www.medscape.com/viewarticle/494060_6

(who is betting, and what are the differing opinions??) --- D

  • Author

Thank you for the articles I practice in a free standing CT/MRI clinic but the info helped prove my point.

  • Admin

Cool. :)

Keep in mind IV contrast is also a diuretic so it is important to hydrate before and after the injection. In a patient without renal insuficency I am comfortable with PO hydration rather than IV.

Jeremy

We recently have been checking the GFR (glomerular filtration rate) in addition to the creatinine. If your lab is not reporting this you can go to www.nkdep.nih.gov and use the calculator. If the GFR is

Creatinine over 1.6 we administer 1/2 of the contrast dose and hydrate afterwards.

  • Admin

We do use Visipaque (iodixanol) for creat >1.5 AND eGFR

IR uses Visipaque exclusively.

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