Esur guidelines contrast media pdf

The committee has covered renal and nonrenal adverse events and other aspects of contrast media. This is a preview of subscription content, access via your institution. Rent this article via DeepDyve. Contrast media induced nephrotoxicity: a consensus report.

Eur Radiol ;— Hospital acquired renal insufficiency: a prospective study. Am J Med ;— Hospital-acquired renal insufficiency. Am J Kidney Dis ;— PubMed Article Google Scholar.

Solomon R. Contrast medium-induced acute renal failure. Kidney Int ;— The prognostic implications of further renal function deterioration with 48 h of interventional coronary procedures in patients with pre-existent chronic renal insufficiency. J Am Coll Cardiol ;— Acute renal failure after coronary intervention: incidence, risk factors and relationship to mortality. Nephrotoxicity of ionic and nonionic contrast media in patients: a randomized trial.

Google Scholar. Report of the Radionuclide in Nephrourology Committee on renal clearance. J Nucl Med ;— Predictive performance of renal function equations for patients with chronic kidney disease and normal serum creatinine levels. J Am Soc Nephrol ;— Screening early renal failure: cut-off values for serum creatinine as an indicator of renal impairment.

In which patients should serum-creatinine be measured before contrast medium administration? Thomsen HS. Contrast nephropathy. Trends in contrast media. Berlin: Springer-Verlag, — Morcos SK. Prevention of contrast media nephrotoxicity—the story so far. Clin Radiol ;— Effects of saline, mannitol and furosemide on acute decreases in renal function induced by radiocontrast agents. N Engl J Med ;— Prospective randomized study of N-aceyltylcysteine, fenoldopam and saline for prevention of radiocontrast-induced nephropathy.

Catheter Cardiovasc Intervent ;— Prevention of contrast media-associated nephropathy. Randomized comparison of 2 hydration regimens in patients undergoing coronary angioplasty. Arch Intern Med ;— A randomized prospective trial to assess the role of saline hydration on the development of contrast nephrotoxicity.

Nephron Clin Pract ;c29—c Prevention of contrast-induced nephropathy with sodium bicarbonate. A randomized controlled trial. JAMA ;— Dialysis and contrast media. PubMed Google Scholar. Effect of haemodialysis after contrast medium administration in patients with renal insufficiency. Nephrol Dial Transplant ;— Pre-emptive haemodialysis after radiocontrast media in patients with renal insufficiency is potentially harmful.

Simultaneous hemodialysis during coronary angiography fails to prevent radiocontrast-induced nephropathy in chronic renal failure. Clin Nephrol ;— Haemodialysis of the prevention of contrast-induced nephropathy. Outcome of 31 patients with severely impaired renal function, comparison with patients at similar risk and review. We hope that you find our guidelines very helpful in your daily practice. This website uses cookies to improve your experience while you navigate through the website.

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Privacy Overview. Necessary Always Enabled. Autono- contrast agents [58]. Because contrast medium solutions contain Interactions between drugs and contrast agents are gen- some free iodide, contrast media may induce thyrotoxi- erally subdivided into a drugs that will be retained in cosis in the above-mentioned patient groups. Iodine the body because of decreased renal function induced by deficiency is an important factor in the development of contrast media, b drugs that enhance the renal effects thyroid autonomy and goiter.

Therefore, iodine-induced of contrast media, c drugs that enhance allergic-like thyrotoxicosis is more commonly seen in areas with low reactions to contrast media, d drugs that interfere with iodine intake. However, in general, contrast medium— the hematologic effects of contrast media, e contrast induced thyrotoxicosis is rare.

Contrast medium media and neuroleptic drugs, f drugs that enhance the injection does not affect thyroid function tests e. Routine monitoring of thyroid function media with other drugs, and i effects of contrast media tests before contrast medium injection in patients with a on biochemical assays. Patients at risk of developing drug history and keeping proper records of injection of thyrotoxicosis after contrast medium injection are pa- contrast medium time, dose, and name.

Patients who tients with Graves disease and patients with multinodu- take drugs, such as metformin cyclosporine, cisplatin, lar goiter with thyroid autonomy, especially elderly aminoglycosides, nonsteroid anti-inflammatory drugs, patients and patients living in areas of iodine deficiency.

One should never mix contrast media with other drugs in The CMSC does not recommend prophylaxis in general, tubes or syringes. The CMSC recommends performing but prophylaxis may offer some protection in selected no biochemical analysis on blood or urine collected high-risk individuals. Administering iodinated contrast within 24 h of contrast medium injection. Contrast media to patients with manifest hyperthyroidism is medium injection should be avoided for at least 24 h absolutely contraindicated.

The free iodide load of con- before the isotopic study of the bone and before labeling trast media injections interferes with iodide uptake in the red blood cells for isotopic studies [59]. Ultrasound contrast media for intravenous injections are usually gas-filled microbubbles with a mean diameter smaller than that of a red blood corpuscle.

Contrast Use of iodinated and gadolinium contrast media agents can be described according to the concentration of during pregnancy and lactation the particles, size of the particles or microbubbles, vol- Mutagenic and teratogenic effects have not been de- ume of gas, kind of gas, kind of shell, additives, etc. Free iodide in radiographic contrast and they are all based on microbubbles.

Neonatal thyroid func- creased backscattering intensity as compared with that tion should be checked during the first week if iodinated from blood, other fluids, and most tissues. Ultrasound contrast media have been given during pregnancy. The contrast agents approved for clinical use are well toler- CMSC considers this check mandatory; in many coun- ated and serious adverse reactions are rarely observed. No Adverse events are usually minor e. These trast media. Morcos: ESUR guidelines on contrast media materials because they have also been observed in pla- observed with other types of contrast media such as cebo control groups.

Intolerance to some components nausea, vomiting, urticaria, rash, and generalized ana- may occur. It may be dangerous to use them in con- phylactoid reactions. Back pain may also occur with nection with echocardiography in patients with very se- superparamagnetic iron oxides. Serious life-threatening vere heart disease. Generalized allergic-like reactions reactions are rare.

Iron oxides are contraindicated in occur rarely. However, ultrasound contrast agents are patients with known allergy or hypersensitivity to par- generally safe.

The CMSC recommends that ultrasound enteral iron or dextran and should be used with caution scanning time and the acoustic output are kept to the in patients with hemosiderosis or hemochromatosis be- lowest level consistent with obtaining diagnostic infor- cause their iron overload may be aggravated. Manga- mation [60]. Adverse reactions should be treated nese-based contrast media are contraindicated in patients symptomatically Table 2. Knowledge about the oral agent and its contra- Liver-specific contrast agents were developed after con- indications are still limited.

Gadolinium-based contrast ventional extracellular gadolinium chelates and few data media are contraindicated in patients with known allergy exist about their safety.

They belong to different classes to the preparation, and the agent with high hepatocyte of agents and therefore exhibit different physiochemical uptake should be used with caution in patients with liver properties, modes of action, and metabolic pathways. In and renal failure and the one with low hepatic uptake in each category, at least one agent has been approved for patients with renal failure [71]. Liver-specific contrast References agents are increasingly used to better detect and char- 1.

They offer the additional Media Safety Committee of the European Society of Urogenital Radiology ESUR Contrast media induced nephrotoxicity: advantages of longer retention by the liver and thus a a consensus report. Eur Radiol — longer window of time for imaging and liver-specific 2.

They include superparamagnetic iron oxide renal insufficiency: a prospective study. Am J Med — 3. Nash K, Hafeez A, Hou S Hospital-acquired renal insuffi- particles, manganese-based preparations manganese ciency.

Am J Kidney Dis — chelate such as mangafodipir trisodium, and free man- 4. Solomon R Contrast medium-induced acute renal failure. J Am Coll Cardiol — 6. The oral agent containing relationship to mortality. Am J Med — manganese is still awaiting approval. Manganese-based 7. The su- trial. Kidney Int — perparamagnetic iron oxide particles differ from the 8. J Nucl Med — mainly T2 agents associated with a decrease in signal 9.

Bostrom AG, Kronenberg F, Ritz E Predictive performance of intensity and accumulation in the reticuloendothelial renal function equations for patients with chronic kidney disease and cells , whereas the latter are mainly T1 agents associated normal serum creatinine levels. J Am Soc Nephrol — Couchoud C, Pozet N, Labeeuw M, Pouteil-Noble C with an increase in signal intensity and accumulation in Screening early renal failure: cut-off values for serum creatinine as hepatocytes.

Although theoretical safety concerns exist, an indicator of renal impairment. Kidney Int — MR contrast agents have been clinically shown to be safe The rate of adverse events seems In which patients should serum-creatinine be measured be- higher with liver-specific contrast agents than with fore contrast medium administration? Eur Radiol — extracellular gadolinium chelates [61, 67, 68]. However, Thomsen HS Contrast nephropathy. Trends in contrast media. Berlin: the incidence of adverse events has not been studied in Springer-Verlag, pp — randomized clinical trials.

In addition, the mode of Morcos SK Prevention of contrast media nephrotoxi- administration of superparamagnetic iron oxide parti- city—the story so far. Clin Radiol — N Engl J Med — [62, 65, 69, 70]. The same applies to oral versus intra- The prevention of radiocontrast-induced nephropathy.

Morcos: ESUR guidelines on contrast media Randomized comparison of 2 patients at increased risk of adverse reactions to intravascular hydration regimens in patients undergoing coronary angio- contrast agents letter. Clin Radiol — plasty. Arch Intern Med — Clin Radiol ment of contrast nephrotoxicity. Nephron Clin Pract c29—c34 A ran- contrast agents letter. Clin Radiol — domized controlled trial. JAMA — Lasser EC Corticosteroid prophylaxis in patients at in- Eur Radiol Nephrol Dial Transplant — Am J Med — report and guidelines.

Eur Radiol — Thomsen HS, Bush WH Treatment of the adverse effects of modialysis during coronary angiography fails to prevent radio- contrast media. Acta Radiol — contrast-induced nephropathy in chronic renal failure. Clin AJR — Outcome of 31 agents and premedication to reduce the frequency of adverse patients with severely impaired renal function, comparison with reactions to radiographic contrast media: a survey of the Society of patients at similar risk and review.

Invest Radiol — Uroradiology. Radiology — Thomsen HS, Dorph S High-osmolar and low-osmolar radiocontrast-agent—induced nephropathy by hemofiltration.