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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).

Pathway Overview

11 steps

Algorithm Steps

11 total

  1. 01Start

    Contrast CT/Angiography Planned

  2. 02Decision

    eGFR Level

    • ≥45
    • 30-44
    • <30
  3. 03End

    Low Risk (eGFR ≥45)

    Proceed, no precautions

  4. 04Action

    Moderate Risk (30-44)

    Consider hydration

  5. 05Action

    IV Hydration

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

  6. 06End

    Proceed with Low-Volume Contrast

    Monitor Cr 48-72h post

  7. 07Decision

    High Risk (eGFR <30)

    • Dialysis
    • Non-dialysis CKD
  8. 08End

    Dialysis Patient

    Contrast okay, coordinate with nephrology

  9. 09Decision

    Contrast Essential?

  10. 10End

    Non-Contrast Alternative

  11. 11End

    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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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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