True or False: Statin pretreatment can help reduce the risk of contrast-induced AKI in statin-naive patients.

• A. FALSE
• B. TRUE
• C. Not studied
• D. Only with high-dose statins

Answer: (B)

Starting statin therapy before contrast exposure is a strategy studied to reduce the risk of contrast-induced AKI, even in patients not previously on statins. The idea is that statins have anti-inflammatory and antioxidant effects as well as improvements in endothelial function and renal blood flow. These pleiotropic actions can blunt the hemodynamic and inflammatory insults caused by contrast, helping to prevent acute kidney injury.

Clinical trials and meta-analyses have shown that short-term, pre-procedure statin pretreatment—often using higher doses started within 24 hours before the contrast study—can reduce the incidence of CI-AKI in statin-naive patients, particularly among those at higher risk (eg, with CKD or vascular disease). While results vary and dosing regimens differ, the overall evidence supports a protective effect, making the statement true.