AMACING: A MAastricht contrast-induced nephropathy guideline project; Evaluation of guideline-recommended prophylaxis to prevent contrast-induced nephropathy

The year 2019 will likely see 250 million injections with iodinated contrast material worldwide, in procedures such as CT scans and cardiac imaging. Even though modern contrast materials are relatively inert, injection may have haemodynamic consequences. The kidneys, charged with elimination of contrast from our bodies, are likely to be most at risk of injury (contrast-induced nephropathy, CIN).

Clinical practice guidelines have been issued worldwide, recommending standard intravenous hydration for at-risk patients. This prophylaxis requires 8-24h hospitalization and confers substantial burden on patients, hospitals, and health care budgets. However, effectiveness had not been properly investigated before its introduction as standard care.

This dissertation describes our evaluation of guideline-recommended prophylactic intravenous hydration for the prevention of CIN, the surprising results, and how they radically altered clinical practice.