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European Radiology
Published in: European Radiology 7/2018

Open Access 01-07-2018 | Contrast Media

Post-contrast acute kidney injury. Part 2: risk stratification, role of hydration and other prophylactic measures, patients taking metformin and chronic dialysis patients

Recommendations for updated ESUR Contrast Medium Safety Committee guidelines

Authors: Aart J. van der Molen, Peter Reimer, Ilona A. Dekkers, Georg Bongartz, Marie-France Bellin, Michele Bertolotto, Olivier Clement, Gertraud Heinz-Peer, Fulvio Stacul, Judith A. W. Webb, Henrik S. Thomsen

Published in: European Radiology | Issue 7/2018

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Abstract

Objectives

The Contrast Media Safety Committee (CMSC) of the European Society of Urogenital Radiology (ESUR) has updated its 2011 guidelines on the prevention of post-contrast acute kidney injury (PC-AKI). The results of the literature review and the recommendations based on it, which were used to prepare the new guidelines, are presented in two papers.

Areas covered in part 2

Topics reviewed include stratification of PC-AKI risk, the need to withdraw nephrotoxic medication, PC-AKI prophylaxis with hydration or drugs, the use of metformin in diabetic patients receiving contrast medium and the need to alter dialysis schedules in patients receiving contrast medium.

Key points

• In CKD, hydration reduces the PC-AKI risk
• Intravenous normal saline and intravenous sodium bicarbonate provide equally effective prophylaxis
• No drugs have been consistently shown to reduce the risk of PC-AKI
• Stop metformin from the time of contrast medium administration if eGFR < 30 ml/min/1.73 m 2
• Dialysis schedules need not change when intravascular contrast medium is given
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Metadata
Title
Post-contrast acute kidney injury. Part 2: risk stratification, role of hydration and other prophylactic measures, patients taking metformin and chronic dialysis patients
Recommendations for updated ESUR Contrast Medium Safety Committee guidelines
Authors
Aart J. van der Molen
Peter Reimer
Ilona A. Dekkers
Georg Bongartz
Marie-France Bellin
Michele Bertolotto
Olivier Clement
Gertraud Heinz-Peer
Fulvio Stacul
Judith A. W. Webb
Henrik S. Thomsen
Publication date
01-07-2018
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 7/2018
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-017-5247-4

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