An elderly patient with a glomerular filtration rate is scheduled for a CT scan with contrast. Which of the following can be provided to the patient to prevent any further renal damage?
1. vitamin B 12
2. vitamin D
3. N-acetylcystine
4. intravenous infusion of 5% dextrose
3
Rationale: Since the use of contrast dyes can be nephrotoxic, steps must be taken to minimize nephrotoxicity. The patient should be adequately hydrated with sodium chloride. N-acetylcystine may be given orally or intravenously before contrast administration. N-acetylcystine acts as a free radical scavenger, counteracts vasoconstriction from contrast agents, and indirectly exhibits cyoprotective effects. The patient should be provided with N-acetylcystine prior to the CT scan with contrast. Vitamin B 12, vitamin D, and a dextrose 5% solution do not help reduce the nephrotoxic effects of contrast dyes.
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