furosemide + isotonic saline

Furosemide + isotonic saline, often administered using the RenalGuard system, is a therapeutic intervention designed to prevent contrast-induced nephropathy (CIN) in high-risk patients undergoing procedures involving radiocontrast agents. The protocol, evaluated in the MYTHOS study sponsored by Centro Cardiologico Monzino, involves inducing high-volume diuresis with the loop diuretic furosemide while simultaneously providing real-time, matched intravenous hydration with isotonic saline. This approach maintains the patient's fluid balance (euvolemia) while ensuring a high flow rate through the kidneys, which dilutes the contrast media and reduces its transit time in the renal tubules, thereby mitigating direct toxic effects and obstructive damage. The therapy is particularly indicated for patients with pre-existing renal impairment (e.g., eGFR < 60 ml/min) undergoing cardiac catheterization.

Brand names

RenalGuard

Other names

Furosemide and matched saline hydrationMatched hydration therapyInduced diuresis with matched hydrationo-Centro Cardiologico Monzino-contrast-induced nephropathy