From the Research
Febuxostat is not recommended for the prevention of contrast-induced nephropathy (CIN) as there is no recent, high-quality evidence supporting its use for this indication. The provided evidence does not mention Febuxostat as a preventive measure for CIN. Instead, studies suggest that hydration with intravenous normal saline 1, N-acetylcysteine 2, 3, and the use of iso-osmolar contrast media 4 may help prevent CIN. Additionally, a recent review highlights the importance of proper contrast medium use, personalized hydration, and high-dose statins in reducing the occurrence of CIN, while antioxidants, including Febuxostat, have not shown significant therapeutic benefits 5.
When considering prevention strategies for CIN, it is essential to identify patients at risk, including those with pre-existing kidney dysfunction, diabetes, advanced age, or dehydration. Standard preventive measures for CIN should include:
- Adequate hydration with intravenous normal saline (1 mL/kg/hr for 12 hours before and after the procedure)
- Using the minimum necessary volume of contrast
- Monitoring renal function before and 48-72 hours after the procedure to assess for any kidney injury
In the absence of strong evidence supporting the use of Febuxostat for CIN prevention, these standard measures should be prioritized to minimize the risk of kidney injury in high-risk patients undergoing procedures with iodinated contrast media.