Be especially careful in patient with GFR less than 60.
AKI
CKD
1. reduce dose
2. no clear evidence for low osmolality agents yet, maybe soon
Also consider carbon dioxide for vascular studies
3. pre-hydrate with IV fluids
4. weak evidence for N-acetylcysteine 600mg BID for two days before
5. hemodialsis vs hemofiltration, may work, but only in exceptional circumstances
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