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Contrast-medium-induced nephropathy: is there a new consensus? A review of published guidelines

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Abstract

The interest in contrast-medium-induced nephropathy has increased considerably during the last few years. Various guidelines regarding identifying patients at risk and measures to reduce the incidence of this complication have been proposed. The aim of this review was to analyse whether there is some consistency amongst these guidelines. A Medline search for the keyword “contrast medium induced nephropathy” during the period from the beginning of 2003 through the end of September 2005 was carried out. Only papers in English were reviewed. Thirteen guidelines were identified. Inconsistency was observed regarding advise on the prophylactic use of drugs and the isoosmolar dimer to reduce the incidence of contrast-medium-induced nephropathy. Consistency was found in relation to the importance of hydration, cessation of intake of nephrotoxic drugs and administration of the lowest possible dose of contrast medium. No new consensus has been observed in comparison to the European Society for Urogenital Radiology (ESUR) guidelines, which were published in 1999.

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References

  1. Tippins RB, Torres WE, Baumgartner BR, Baumgarten DA (2000) Are screening serum creatinine levels necessary prior to outpatient CT examinations? Radiology 216:481–484

    PubMed  CAS  Google Scholar 

  2. Choyke PL, Cady K, DePollar SL, Austin H (1998) Determination of serum creatinine prior to iodinated contrast media: is it needed in all patients? Tech Urol 4:65–69

    PubMed  CAS  Google Scholar 

  3. Olsen JC, Salomon B (1996) Utility of the creatinine prior to intravenous contrast studies in the emergency department. J Emerg Med 14:543–546

    Article  PubMed  CAS  Google Scholar 

  4. The Committee on Drugs and Contrast Media of the American College of Radiology (2005) ACR manual on contrast media. American College of Radiology, 1981 Preston White Drive, Reston, VA 20191–4378, USA

  5. Thomsen HS, Morcos SK, Members of Contrast Media Safety Committee of European Society of Urogenital Radiology (ESUR) (2005) In which patients should serum-creatinine be measured before contrast medium administration? Eur Radiol 15:749–756

    Article  PubMed  Google Scholar 

  6. Lin J, Bonventre JV (2005) Prevention of radiocontrast nephropathy. Curr Opin Nephrol Hypertens 14:105–110

    Article  PubMed  CAS  Google Scholar 

  7. Mehran R, Aymong ED, Nikolsky E et al (2004) A simple risk score for prediction of contrast-induced nephropathy after percutaneous coronary intervention. Development and initial validation. J Am Coll Cardiol 44:1393–1399

    PubMed  Google Scholar 

  8. Bartholomew BA, Harjai KJ, Dukkipati S et al (2004) Impact of nephropathy after percutaneous coronary intervention and a method for risk stratification. Am J Cardiol 93:1515–1519

    Article  PubMed  Google Scholar 

  9. Gleeson T, Bulugahapitiya S (2004) Contrast induced nephropathy. AJR Am J Roentgenol 183:1673–1689

    PubMed  Google Scholar 

  10. Gleeson TG, O’Dwyer J, Bulugahapitiya S, Foley D (2004) Contrast-induced nephropathy. Br J Cardiol 11:AIC 53–AIC 61

    Google Scholar 

  11. Erdogan A, Davidson CJ (2003) Recent clinical trials of iodixanol. Rev Cardiovasc Med 4(Suppl 5):S43–S50

    PubMed  Google Scholar 

  12. Cox CD, Tsikouris JP (2004) Preventing contrast nephropathy: what is the best strategy? A review of the literature. J Clin Pharmacol 44:327–337

    Article  PubMed  Google Scholar 

  13. McCullough PA, Soman SS (2005) Contrast-induced nephropathy. Crit Care Clin 21:261–280

    Article  PubMed  Google Scholar 

  14. Briguori C, Airoldi F, Colombo A (2005) Prevention of contrast nephropathy. Cardiol Int Autumn, 84–90

  15. Goldenberg I, Matetzky S (2005) Nephropathy induced by contrast media: pathogenesis, risk factors and preventive strategies. CMAJ 172:1461–1471

    PubMed  Google Scholar 

  16. Weisbord SD, Palevsky PM (2005) Radiocontrast-induced acute renal failure. J Intensive Care Med 20:63–75

    Article  PubMed  Google Scholar 

  17. Morcos SK, Thomsen HS, Webb JAW and members of contrast media safety committee of the European Society of Urogenital Radiology (ESUR) (1999) Contrast media induced nephrotoxicity: a consensus report. Eur Radiol 9:1602–1613

    Article  PubMed  CAS  Google Scholar 

  18. Merten GJ, Burgess WP, Gary LV et al (2004) Prevention of contrast-induced nephropathy with sodium bicarbonate. A randomized controlled trial. JAMA 291:2328–2334

    Article  PubMed  CAS  Google Scholar 

  19. Bakris GL, Lass N, Gabaer AO, Jones JD, Burnette JC Jr (1990) Radiocontrast medium-induced declines in renal function. A role for oxygen free radicals. Am J Physiol 175:57–60

    CAS  Google Scholar 

  20. Atkins JL (1986) Effect of sodium bicarbonate preloading on ischemic renal failure. Nephron 44:70–76

    Article  PubMed  CAS  Google Scholar 

  21. Morcos SK (2005) Prevention of contrast media-induced nephrotoxicity after angiographic procedures. J Vasc Interv Radiol 16:13–23

    PubMed  Google Scholar 

  22. Thomsen HS (2006) Reducing the risk of contrast media induced nephrotoxicity. In: Thomsen HS (ed) Contrast media: safety issues and ESUR Guidelines. Springer, Heidelberg Berlin New York, pp 53–55

    Chapter  Google Scholar 

  23. Aspelin P, Aubry P, Fransson S-G et al (2003) Nephrotoxic effects in high-risk patients undergoing angiography. N Engl J Med 348:491–499

    Article  PubMed  CAS  Google Scholar 

  24. Baker CS, Wragg A, Kumar S, De Palma R, Baker LR, Knight CJ (2003) A rapid protocol for the prevention of contrast-induced renal dysfunction: the RAPPID study. J Am Coll Cardiol 41:2114–2118

    Article  PubMed  Google Scholar 

  25. Boccolandro F, Amhad M, Smalling RW, Sdringola S (2003) Oral acetylcysteine does not protect protect renal function from moderate to high doses of intravenous radiographic contrast. Cathet Cardiovasc Interv 58:336–341

    Article  Google Scholar 

  26. Stone GW, McCullough PA, Tumlin JA et al (2003) CONTRAST investigators. Fenoldopam mesylate for the prevention of contrast-induced nephropathy: a randomized controlled trial. JAMA 290:2284–2291

    Article  PubMed  CAS  Google Scholar 

  27. Briguori C, Colombo A, Airoldi F et al (2005) Nephrotoxocity of low-osmolality versus iso-osmolality contrast agents: impact of N-acetylcysteine. Kidney Int 68:2250–2255

    Article  PubMed  CAS  Google Scholar 

  28. Solomon R (2005) The role of osmolality in the incidence of contrast-induced nephropathy: A systematic review of angiographic contrast media in high risk patients. Kidney Int 68:2256–2263

    Article  PubMed  CAS  Google Scholar 

  29. Bettmann MA (2005) Contrast medium-induced nephropathy: critical review of the existing clinical evidence. Nephrol Dial Transplant 20(suppl 1):i2–i7

    Google Scholar 

  30. Hoffmann U, Fischereder M, Kruger B, Drobnik W, Kramer BK (2004) The value of N-acetylcysteine in the prevention of radiocontrast agent-induced nephropathy seems questionable. J Am Soc Nephrol 15:407–410

    Article  PubMed  CAS  Google Scholar 

  31. Morcos SK, Thomsen HS, Webb JAW, Members of the Contrast Media Safety Committee of European Society of Urogenital Radiology (2002) Dialysis and contrast media. Eur Radiol 12:3026–3030

    PubMed  Google Scholar 

  32. Barrett BJ, Parfrey PS (2006) Preventing nephropathy induced by contrast medium. N Engl J Med 354:379–386

    Article  PubMed  CAS  Google Scholar 

  33. Higgins JPT, Thompson SG, Deeks JJ, Altman DG (2003) Measuring inconsistency in meta-analysis. Br Med J 327:557–560

    Article  Google Scholar 

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Authors and Affiliations

  1. Department of Diagnostic Radiology 54E2, Copenhagen University Hospital at Herlev, Herlev Ringvej 75, DK-2730, Herlev, Denmark

    Henrik S. Thomsen

  2. Department of Diagnostic Imaging, Northern General Hospital, Sheffield Teaching, Hospitals NHS Foundation Trust, Sheffield, S5 7AU, UK

    Sameh K. Morcos

Authors
  1. Henrik S. Thomsen
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  2. Sameh K. Morcos
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Correspondence to Henrik S. Thomsen.

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Thomsen, H.S., Morcos, S.K. Contrast-medium-induced nephropathy: is there a new consensus? A review of published guidelines. Eur Radiol 16, 1835–1840 (2006). https://doi.org/10.1007/s00330-006-0223-4

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  • DOI: https://doi.org/10.1007/s00330-006-0223-4

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