Michel P, Amione-Guerra J, Sheikh O, et al. - The occurrence of contrast-associated acute kidney injury (CA-AKI) can be effectively prevented by IV volume expansion, although a high variability exists in protocols employed. Reduced risk of CA-AKI was observed in relation to intensive IVF expansion (median 1.6 L over 17 hr).

• This literature review and meta-analysis was conducted including 37 randomized controlled trials of patients (n=12,166; mean age: 67 ± 5 years) receiving IV volume expansion as prophylaxis for CA-AKI.

• CA-AKI incidence was 9.5%, and a lower risk of CA-AKI (RR:0.62) was reported with IV expansion vs no volume administration.

• A decrease in the risk of CA-AKI (RR: 0.66) was achieved with intensive IV volume expansion.

• The intensive IV volume expansion arm was administered significantly more fluids compared with the standard protocols: 1,574(1,123 – 1,913) ml vs 849(558–1,067) ml without significant difference in the duration of infusion (median of 12 vs 17 hr) or pulmonary edema (1.7% vs 1.3%).