There is increasing literature that supports the notion that radiocontrast administration does not increase the risk of developing acute kidney injury.

In this meta-analysis, contrast-enhanced CT scan vs non-contrast CT did not show significant differences in rates of acute kidney injury, need for renal replacement therapy, or mortality.

In patients with eGFR 30-59, there was no benefit to giving saline prior to IV contrast for CT.

There was no association with IV contrast for CT and short-term acute kidney injury or progression to dialysis at 6 months, regardless of initial GFR in patients with a creatinine < 4.

Early IV fluid administration benefited patients with HUS and drastically reduced the odds of oliguria, need for dialysis, and death.

IV fluids with NS + bicarb or NS + NAC or plain NS did not prevent contrast nephropathy in patients getting CTPA.

For every 100 meq of increased chloride load in patients needing large amounts of isotonic fluid, hazard for death increased 5.5% even after controlling for potential confounders.