Preventing Contrast-Induced Nephropathy: A Narrative Review of an Interdisciplinary Protocol Integrating Radiology, Nursing, Pharmacy, and Physiotherapy
Abstract
Background: Contrast-Induced Nephropathy (CIN) is a significant iatrogenic complication following intravascular contrast media administration, associated with increased morbidity, mortality, and healthcare costs. Its prevention is a quintessential model for interdisciplinary care, requiring precise coordination beyond the radiology suite.
Aim: This narrative review aims to synthesize evidence on developing and implementing a collaborative, multi-disciplinary protocol for CIN prevention, integrating the specialized roles of radiology, nursing, pharmacy, and physiotherapy.
Methods: A systematic literature search of PubMed, EMBASE, CINAHL, and the Cochrane Library (2010-2024) was conducted. Keywords included contrast-induced nephropathy, acute kidney injury, hydration protocols, pharmacist-led medication review, interdisciplinary communication, and preventive nephrology. Included studies were systematic reviews, randomized controlled trials, observational studies, and quality improvement reports.
Results: Effective CIN prevention hinges on a systematized pathway: risk stratification guided by radiologists and informed by pharmacist-led medication reconciliation (e.g., withholding nephrotoxic agents); nurse-driven, protocol-based intravenous hydration; and physiotherapy-guided monitoring of volume status and mobility to prevent fluid overload. The integration of these roles into a single protocol significantly improves guideline adherence, reduces CIN incidence, and enhances patient safety.
Conclusion: CIN prevention is maximized not by isolated interventions but through a structured, collaborative framework. This review advocates for standardized, interdisciplinary protocols as the standard of care for at-risk patients undergoing contrast-enhanced procedures.
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References
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Copyright (c) 2024 Bshayer Saleh ud Alrush, Hasna mohammed Alshammari, Hend Mohammed Hakami, Ali Abdullah Ali Khobrani, Saleh Mater Alosaimi, Turki Hassan Alamri, Aziz Hamoud Sari Al-Otaibi, Norh Ahmed Ahmed Algope, Neam Albandari Abdallah Aldawsary, Tahani Mohammed Hakami, Fawaz Nawaz Alanazi, Saad Abdullah Alanazi, Mohammed Saud Saad Alsaedi
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