|R||Risk assessment with pre-procedural planning; no left ventriculography; manage contrast from beginning of the case; stage PCI, if possible, to delay contrast re-exposure 48–72 h|
|E||eGFR: know baseline renal function of all patients; treat patients with eGFR <60 ml/min/1.73 m2 as high risk; special attention for very high risk (eGFR <30 ml/min/1.37 m2), with nephrology involvement as appropriate|
|N||Normal saline: pre- and post-hydration with isotonic crystalloid solutions|
|A||Avoid nephrotoxic drugs, dehydration, and prior contrast exposure|
|L/L||Low-osmolar/iso-osmolar contrast: long-term follow-up with post-procedural Cr check, preferably at 48–72 h|
Cr = creatinine; eGFR = estimated glomerular filtration rate; PCI = percutaneous coronary intervention.