Department of Medicine, Division of Nephrology, Icahn School of Medicine at Mount Sinai, New York, USA.
Department of Medicine, Division of Nephrology, Icahn School of Medicine at Mount Sinai, New York, USA.
Kidney Int. 2017 Jul;92(1):4-6. doi: 10.1016/j.kint.2017.04.005. Epub 2017 May 18.
Clinical guidelines recommend prophylactic hydration to reduce the risk of contrast-induced nephropathy in high-risk patients, including those with chronic kidney disease. A recent single-center randomized trial showed no significant difference in the incidence of contrast-induced nephropathy in ambulatory patients with stage 3 chronic kidney disease who were randomized to no prophylactic hydration versus normal saline hydration. While these results may identify patients who are less likely to benefit from prophylactic hydration, nephrologists and interventionalists should carefully consider the generalizability of these results to individual patients.
临床指南建议对高危患者（包括慢性肾脏病患者）进行预防性水化，以降低对比剂肾病的风险。最近的一项单中心随机试验显示，在随机分为无预防性水化与生理盐水水化的 3 期慢性肾脏病门诊患者中，对比剂肾病的发生率无显著差异。虽然这些结果可能确定了那些不太可能从预防性水化中获益的患者，但肾病学家和介入放射学家应仔细考虑这些结果对个体患者的可推广性。
