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KMID : 1012120230110010001
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Evidence and Nursing
2023 Volume.11 No. 1 p.1 ~ p.6
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Evidence-based Nursing Case on Prevention of Contrast-induced Nephrotoxicity in Patients with Renal Insufficiency
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Cho Young-Jin
Cho Yoon-Joo
Shin So-Ra
Kwon Ji-Hye
Kim Sun-Kyung
Park Jeong-Ok
Lee Mi-Jeong
Lee Hyun-Jin
Ahn Jeong-Ah
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Abstract
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Purpose: This study aimed to determine the impact of oral or intravenous fluid therapy to prevent contrast-induced nephrotoxicity in patients with renal insufficiency undergoing contrast-enhanced computed tomography (CT).
Methods: We searched five electronic databases and reviewed prior studies according to the criteria. Finally, three randomized controlled trials (RCTs) and one non-randomized study of intervention (NRSI) were selected.
Results: According to the Scottish Intercollegiate Guidelines Network, the quality evaluation was checked, and the results were 1++ for one RCT, 1+ for two RCTs, and 2+ for one NRSI. There was an insufficient beneficial evidence of pretreatment with intravenous fluid therapy to prevent contrast-induced nephrotoxicity in patients with reduced renal function undergoing contrast-enhanced CT.
Conclusion: We recommend that patients with renal insufficiency with an estimated glomerular filtration rate (eGFR) of 45~59 mL/min/1.73 m² can undergo contrast-enhanced CT without oral or intravenous fluid therapy as a pretreatment agent, and those with eGFR of 30~44 mL/min/1.73 m² can be treated with oral hydration treatment to prevent contrast- induced nephrotoxicity. However, for patients with high risks, the decision to administer pretreatment should be considered according to the individual patient’s clinical condition and the clinical expertise of healthcare providers
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KEYWORD
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Evidence-based nursing, Oral administration, Fluid therapy, Contrast media, Renal insufficiency
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