Trombara F, Cosentino N, Pontone G, Marenzi G. Renal replacement therapies in the prevention of contrast-induced acute kidney injury. World J Nephrol 2026; 15(3): 119548 [DOI: 10.5527/wjn.v15.i3.119548]
Corresponding Author of This Article
Nicola Cosentino, MD, PhD, Department of Perioperative Cardiology and Cardiovascular Imaging, Centro Cardiologico Monzino IRCCS, Via Carlo Parea 4, Milan 20138, Lombardy, Italy. nicola.cosentino@cardiologicomonzino.it
Research Domain of This Article
Cardiac & Cardiovascular Systems
Article-Type of This Article
review-article
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This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
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Trombara F, Cosentino N, Pontone G, Marenzi G. Renal replacement therapies in the prevention of contrast-induced acute kidney injury. World J Nephrol 2026; 15(3): 119548 [DOI: 10.5527/wjn.v15.i3.119548]
Filippo Trombara, Centro Cardiologico Monzino IRCCS, Milan 20138, Lombardy, Italy
Nicola Cosentino, Gianluca Pontone, Department of Perioperative Cardiology and Cardiovascular Imaging, Centro Cardiologico Monzino IRCCS, Milan 20138, Lombardy, Italy
Gianluca Pontone, Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan 20138, Italy
Giancarlo Marenzi, Intensive Cardiac Care Unit, Centro Cardiologico Monzino IRCCS, Milan 20138, Italy
Author contributions: Trombara F and Cosentino N designed the research study, performed the research, and wrote the manuscript; Pontone G and Marenzi G critically revised the manuscript. All authors have read and approved the final manuscript.
AI contribution statement: AI was used for language polishing and writing assistance of the manuscript.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Corresponding author: Nicola Cosentino, MD, PhD, Department of Perioperative Cardiology and Cardiovascular Imaging, Centro Cardiologico Monzino IRCCS, Via Carlo Parea 4, Milan 20138, Lombardy, Italy. nicola.cosentino@cardiologicomonzino.it
Received: February 10, 2026 Revised: February 23, 2026 Accepted: April 2, 2026 Published online: September 25, 2026 Processing time: 195 Days and 11.4 Hours
Core Tip
Core Tip: Contrast-associated acute kidney injury remains a major complication in high-risk patients undergoing contrast-based procedures. While standard prevention relies on individualized hydration and contrast minimization, the role of prophylactic renal replacement therapy remains controversial. Evidence consistently shows that hemodialysis does not prevent contrast-associated acute kidney injury, whereas early hemofiltration may offer benefit in carefully selected patients with advanced chronic kidney disease and limited tolerance to fluid expansion. However, inconsistent trial results and logistical constraints preclude routine use. This review critically evaluates current evidence, highlights patient selection and timing considerations, and underscores the need for adequately powered randomized trials.
