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Hydration guided by urine flow rate better for preventing contrast-associated acute kidney injury

Journal
JACC: Cardiovascular Interventions
Reuters Health - 21/09/2020 - Urine flow rate (UFR)-guided hydration using the RenalGuard system is better than left ventricular end-diastolic pressure (LVEDP)-guided hydration for preventing contrast-associated acute kidney injury (CA-AKI), according to findings from the REMEDIAL III trial. "It is generally accepted that hydration is of outmost importance to prevent CA-AKI," Dr. Carlo Briguori of Mediterranea Cardiocentro, in Naples, Italy, told Reuters Health by email. "I am convinced that 'tailored-hydration regimens' will become a gold standard to prevent CA-AKI." The recommended hydration regimen to prevent CA-AKI is normal saline infusion (1 mL/kg/h, reduced to half that for patients with left ventricular ejection fraction 35% or lower or NYHA functional class >II) from 12 hours before to 24 hours after contrast-media exposure. UFR- and LVEDP-guided hydration have been proposed as tailored regimens to improve efficacy and reduce the risk of acute pul...


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