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Contrast-Induced AKI Prevention (ACR/KDIGO)

Contrast-Induced AKI Prevention (ACR/KDIGO): Contrast CT/Angiography Planned → eGFR Level → Low Risk (eGFR ≥45).

Interactive Decision Tree

Mini Map

Algorithm Steps

  1. ▶
    Start

    Contrast CT/Angiography Planned

    1. ◆
      Decision

      eGFR Level

      • ≥45
      • 30-44
      • <30
      1. ■
        End

        Low Risk (eGFR ≥45)

        Proceed, no precautions

      2. ●
        Action

        Moderate Risk (30-44)

        Consider hydration

        1. ●
          Action

          IV Hydration

          NS 1-1.5 mL/kg/h pre and post

          1. ■
            End

            Proceed with Low-Volume Contrast

            Monitor Cr 48-72h post

      3. ◆
        Decision

        High Risk (eGFR <30)

        • Dialysis
        • Non-dialysis CKD
        1. ■
          End

          Dialysis Patient

          Contrast okay, coordinate with nephrology

        2. ◆
          Decision

          Contrast Essential?

          1. ■
            End

            Non-Contrast Alternative

          2. ■
            End

            Proceed with Precautions

            Minimal volume, iso-osmolar, nephro consult

Guideline Source

ACR/KDIGO Contrast-Induced AKI Guidelines

DOI: 10.1007/s00270-019-02269-yView Guideline

Clinical Safety Information

Clinical Decision Support — Not a Substitute for Clinical Judgment

Individual patient factors may require deviation from these recommendations.

Known Limitations

  • Risk of CA-AKI may be overstated
  • IV contrast less nephrotoxic than previously thought
  • Withholding contrast may cause greater harm

Applicable Regions

USAUUKEU

EU: ESUR similar approach

US: ACR updated guidelines de-emphasize CA-AKI risk

Version 1Next review: 2028-01-01

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Emergency

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Frequently Asked Questions

What is the Contrast-Induced AKI Prevention (ACR/KDIGO)?

The Contrast-Induced AKI Prevention (ACR/KDIGO) is a management clinical algorithm for Radiology. It provides a structured decision tree to guide clinical decision-making, based on ACR/KDIGO Contrast-Induced AKI Guidelines.

What guideline is the Contrast-Induced AKI Prevention (ACR/KDIGO) based on?

This algorithm is based on ACR/KDIGO Contrast-Induced AKI Guidelines (DOI: 10.1007/s00270-019-02269-y).

What are the limitations of the Contrast-Induced AKI Prevention (ACR/KDIGO)?

Known limitations include: Risk of CA-AKI may be overstated; IV contrast less nephrotoxic than previously thought; Withholding contrast may cause greater harm. Individual patient factors may require deviation from these recommendations.

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