Potassium Imbalance Management

Question 1

What is defined as a 25% increase in creatinine occurring within 3 days of the intravascular administration of contrast media?

Answer 1

Contrast media nephrotoxicity

This condition is also known as contrast-induced nephropathy.

Question 2

How many days after the administration does contrast-induced nephropathy typically occur?

Answer 2

2 - 5 days

This timeframe can vary based on individual patient factors.

Question 3

What are some risk factors for contrast-induced nephropathy?

Answer 3

• Known renal impairment (especially diabetic nephropathy)
• Age > 70 years
• Dehydration
• Cardiac failure
• Use of nephrotoxic drugs such as NSAIDs

These factors increase the likelihood of developing nephropathy after contrast administration.

Question 4

Which procedures may cause contrast-induced nephropathy?

Answer 4

• CT with contrast
• Coronary angiography/percutaneous coronary intervention (PCI)

Around 5% of patients who undergo PCI develop a transient rise in plasma creatinine concentration.

Question 5

What is the recommended prevention method for contrast-induced nephropathy?

Answer 5

Intravenous 0.9% sodium chloride at a rate of 1 mL/kg/hour for 12 hours pre- and post-procedure

Isotonic sodium bicarbonate may also be beneficial.

Question 6

What medication should be withheld for a minimum of 48 hours in high-risk patients for contrast-induced nephropathy?

Answer 6

Metformin

This is to mitigate the risk of lactic acidosis.

Question 7

True or False: N-acetylcysteine has been shown to be effective in preventing contrast-induced nephropathy.

Answer 7

False

Recent evidence suggests that N-acetylcysteine is not effective.