Radio contrast nephropathy occurs equally in patients with and without renal disease

Diabetics are particularly at high risk of developing radio contrast nephropathy

The patients with radio contrast induce nephropathy present with polyuric renal failure.

The serum creatinine peaks after 12 hours of exposure to contrast.

Answer: The answer is (b). Radio contrast nephropathy occurs with increased frequency among patients with pre existing renal disease. Diabetics have higher risk of developing radio contrast nephropathy. Patients with radio contrast nephropathy present with oliguric renal failure. The serum creatinine peaks after 72 hours of the insult.

Administration of 100 ml of 3% saline 12 hours before the study

Acetylcysteine 600mg orally twice daily starting one day before the procedure and ending on the day of the procedure – a total of 4 doses

Acetylcysteine 150mg intravenous – a total of 4 doses, 2 before and 2 after the procedure.

Administration of 100 ml per hour of normal saline for 24 hours after the procedure.

Answer: The answer is (b). Adequate pre-hydration is essential before the contrast is administered. It is achieved with administering half normal saline at the rate of 100ml per hour beginning 12 hours before the procedure and continuing for 12 hours after the procedure. Acetylcysteine orally in a dose of 600mg twice daily starting on the day before the procedure continuing through the day of the procedure is shown to reduce the risk of contrast induced nephropathy.