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

Research output: Contribution to journalReviewResearchpeer-review

  • 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
  • Thomsen, Henrik S.

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 m2 • Dialysis schedules need not change when intravascular contrast medium is given.

Original languageEnglish
JournalEuropean Radiology
Volume28
Issue number7
Pages (from-to)2856-2869
Number of pages14
ISSN0938-7994
DOIs
Publication statusPublished - 2018

    Research areas

  • Acute kidney injury, Contrast media, Haemodialysis, Metformin, Practice guidelines

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