Use of Intravenous Iodinated Contrast Media in Patients With Kidney Disease: Consensus Statements from the American College of Radiology and the National Kidney Foundation

Overview

Journal Kidney Med

Specialty Nephrology

Date 2020 Oct 5

PMID 33015613

Citations 42

Authors

Matthew S Davenport

Mark A Perazella

Jerry Yee

Jonathan R Dillman

Derek Fine

Robert J McDonald

Roger A Rodby

Carolyn L Wang

Jeffrey C Weinreb

Affiliations

Soon will be listed here.

Abstract

Intravenous iodinated contrast media are commonly used with CT to evaluate disease and to determine treatment response. The risk of acute kidney injury (AKI) developing in patients with reduced kidney function following exposure to intravenous iodinated contrast media has been overstated. This is due primarily to historic lack of control groups sufficient to separate contrast-induced AKI (CI-AKI; ie, AKI caused by contrast media administration) from contrast-associated AKI (CA-AKI; ie, AKI coincident to contrast media administration). Although the true risk of CI-AKI remains uncertain for patients with severe kidney disease, prophylaxis with intravenous normal saline is indicated for patients who have AKI or an estimated glomerular filtration rate less than 30 mL/min/1.73 m who are not undergoing maintenance dialysis. In individual high-risk circumstances, prophylaxis may be considered in patients with an estimated glomerular filtration rate of 30-44 mL/min/1.73 m at the discretion of the ordering clinician.

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