Contrast induced nephropathy: updated ESUR Contrast Media Safety Committee guidelines

• Published in: European radiology Vol. 21; no. 12; pp. 2527 - 2541
• Main Authors: Stacul, Fulvio, van der Molen, Aart J., Reimer, Peter, Webb, Judith A. W., Thomsen, Henrik S., Morcos, Sameh K., Almén, Torsten, Aspelin, Peter, Bellin, Marie-France, Clement, Olivier, Heinz-Peer, Gertraud
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer-Verlag 01.12.2011; Springer Nature B.V
• Subjects: Brand names; Committees; Contrast agents; Contrast Media; Contrast Media - administration & dosage; Contrast Media - adverse effects; Coronary Angiography - adverse effects; Coronary Angiography - methods; Diagnostic Radiology; Europe; Female; Fluid Therapy; Gadolinium - administration & dosage; Gadolinium - adverse effects; Glomerular Filtration Rate; Heart Failure - diagnostic imaging; Humans; Hydration; Imaging; Injections, Intra-Arterial; Injections, Intravenous; Internal Medicine; Interventional Radiology; Iodine; Iodine - administration & dosage; Iodine - adverse effects; Male; Medicine; Medicine & Public Health; Neuroradiology; Practice Guidelines as Topic; Radiology; Renal Insufficiency - chemically induced; Renal Insufficiency - physiopathology; Renal Insufficiency - prevention & control; Risk Factors; Sodium Bicarbonate - administration & dosage; Sodium Chloride - administration & dosage; Ultrasound; Sweden; Austria; United Kingdom > UK; Denmark; Italy; France; Germany; Renal insufficiency, chronic; Iodine-based contrast media; Acute kidney injury; Renal failure; Iodopyridones; Gadolinium; Metformin; Gadolinium-based contrast media; Contrast media; Contrast-induced nephropathy; Contrast medium-induced nephropathy
• ISSN: 0938-7994; 1432-1084; 1432-1084
• DOI: 10.1007/s00330-011-2225-0

Purpose The Contrast Media Safety Committee (CMSC) of the European Society of Urogenital Radiology (ESUR) has updated its 1999 guidelines on contrast medium-induced nephropathy (CIN). Areas covered Topics reviewed include the definition of CIN, the choice of contrast medium, the prophylactic measures used to reduce the incidence of CIN, and the management of patients receiving metformin. Key Points • Definition, risk factors and prevention of contrast medium induced nephropathy are reviewed. • CIN risk is lower with intravenous than intra-arterial iodinated contrast medium. • eGFR of 45 ml/min/1.73 m 2 is CIN risk threshold for intravenous contrast medium. • Hydration with either saline or sodium bicarbonate reduces CIN incidence. • Patients with eGFR ≥60 ml/min/1.73 m 2 receiving contrast medium can continue metformin normally.