skip to main content

Contrast-Associated AKI — ESENeph MCQ

Instant feedback + full explanation. One question, done properly.

EasyAcute Kidney InjuryContrast-Associated AKIESENeph

A 55-year-old man with CKD G3b (eGFR 32 mL/min/1.73m2) needs a contrast-enhanced CT scan for suspected malignancy. He has no diabetes or heart failure. Creatinine is 165 umol/L. What is the most important preventive measure to reduce contrast-associated AKI?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: C — IV isotonic saline hydration before and after the procedure

KDIGO 2012 AKI guideline and NICE recommend IV volume expansion with isotonic saline or sodium bicarbonate as the key preventive measure for contrast-associated AKI in patients with CKD. The PRESERVE trial (2018) showed no benefit of sodium bicarbonate over saline, and no benefit of N-acetylcysteine over placebo. The most important measure is adequate hydration. Withholding nephrotoxic medications (NSAIDs) and using the minimum contrast dose are additional measures.

Reference: KDIGO 2012 – AKI Guideline; Weisbord et al 2018 – PRESERVE Trial, NEJM