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Previous Volume 354:379-386 January 26, 2006 Number 4 Next

	Since this article has no abstract, we have provided an extract of the first 100 words of the full text and any section headings.

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This Journal feature begins with a case vignette highlighting a common clinical problem. Evidence supporting various strategies is then presented, followed by a review of formal guidelines, when they exist. The article ends with the authors' clinical recommendations.

A 71-year-old man with type 2 diabetes and hypertension is referred for coronary angiography. His medications include metformin and a thiazide. Before the angiogram, his serum creatinine level is 1.8 mg per deciliter (160 µmol per liter), yielding an estimated glomerular filtration rate of 40 ml per minute per 1.73 m² of body-surface area. What can be done to reduce the risk . . . [Full Text of this Article]

The Clinical Problem

Risk Factors

Prognosis

Pathogenesis

Strategies and Evidence

Evaluation of Risk

Prevention

            Protocols for Administration of Fluids

            N-acetylcysteine

Other Approaches to Prophylaxis

            Hemodialysis or Hemofiltration

            Choice of Contrast Mediums

Areas of Uncertainty

Guidelines

Summary and Recommendations

Source Information

From the Division of Nephrology, Memorial University of Newfoundland, St. John's, Newf., Canada.

Address reprint requests to Dr. Barrett at the Patient Research Centre, Health Sciences Centre, 300 Prince Philip Dr., St. John's, NL A1B 3V6, Canada, or at bbarrett@mun.ca.

Related Letters:

Preventing Nephropathy Induced by Contrast Medium
Gross J. L., Friedman R., Silveiro S. P., Hellman R. N., Tepel M., Barrett B. J., Parfrey P. S.
Extract | Full Text | PDF  
N Engl J Med 2006; 354:1853-1855, Apr 27, 2006. Correspondence

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