Table 4 Summary of the commonly used approaches for prevention and treatment of CI-AKI
Approaches | Modes of action | Administration route | Dispute |
|---|---|---|---|
Hydration therapy | Improving renal blood flow, diluting the ICM, reducing the renin angiotensin system, and reducing the secretion of antidiuretic. | Intravenous, Oral | 1.Does not recommend the use of oral hydration as the preferred or sole prevention strategy for CI-AKI. 2.There is controversy over the use of bicarbonate. |
NAC | Scavenger of free radicals, vasodilation, precursor for glutathione synthesis, inhibit angiotensin-converting enzyme. | Oral | Recent RCTs or meta-analyses did not show a preventive effect of NAC against CI-AKI. |
Statins | Pleiotropic action, improving endothelial function, maintaining nitric oxide production and reducing free radicals formation through NADPH oxidase activity. | Oral | Patients were cardiac and used multiple statins and standard hydration regimens, these confounding factors contributed to uncertainty in results. |
SGLT2i | Anti-inflammatory, and anti-oxidative | Oral | There is not recommended to prevent CI-AKI in the absence of other indications such as T2DM. |
Vitamin C | Scavenger of oxygen free radicals. | Oral | Most RCTs have not demonstrated that Vitamin C reduces the risk of CI-AKI. |
Theophylline | An adenosine receptor antagonis. | Oral | Uncertain results regarding the effects of theophylline on CI-AKI. |