Contrast induced nephropathy (CIN) remains a common complication of coronary angiography. There is no specific treatment once contrast induced acute renal failure develops, and management must be as for any cause of acute tubular necrosis, with the focus on maintaining fluid and electrolyte balance. The best treatment of CIN is prevention. A variety of preventive measures including the administration of intravenous saline or possibly sodium bicarbonate and the antioxidant acetylcysteine may reduce the risk of CIN.