The fear for contrast-induced nephropathy in kidney transplant recipients: time for a paradigm shift?

A recently published article in the Lancet (AMACING trial) challenges a long-standing clinical consensus: intravenous (i.v.) volume expansion with isotonic saline as a prophylactic measure for iodinated contrast-induced nephropathy (CIN) [1]. The randomized trial showed that - in patients with an estimated glomerular filtration rate (eGFR) of 30-59 mL/min/1.73m², undergoing an elective procedure - as compared to i.v. hydration, no prophylaxis is non-inferior in preventing CIN.