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13:21
Preparation, Purification, and Characterization of Lanthanide Complexes for Use as Contrast Agents for Magnetic Resonance Imaging
Published on: July 21, 2011
[Kidney and iodinated and gadolinium-based contrast agents].
O Clément1, N Faye, L Fournier
1Service de Radiologie, Hôpital Européen Georges-Pompidou, 20 rue Leblanc, 75015 Paris, France. olivier.clement@inserm.fr
Journal De Radiologie
|May 10, 2011
Summary
Patients with kidney problems need careful review before receiving contrast agents. Iodinated contrast agents risk kidney damage, while gadolinium-based contrast agents (GBCAs) can cause nephrogenic systemic fibrosis (NSF).
Area of Science:
- Radiology
- Nephrology
- Pharmacology
Background:
- Contrast agents, including iodinated and gadolinium-based contrast agents (GBCAs), pose risks for patients with renal impairment.
- Evaluation of renal function is critical before administering contrast media to prevent adverse events.
Observation:
- Iodinated contrast agents can cause contrast-induced nephropathy (CIN), particularly in patients with a glomerular filtration rate (GFR) below 60 ml/min.
- Gadolinium-based contrast agents (GBCAs) are associated with nephrogenic systemic fibrosis (NSF) in patients with end-stage renal disease or those undergoing dialysis.
Findings:
- Hydration, preferably intravenous, can reduce the risk of CIN. The GFR threshold for concern may be lowered to 45 ml/min for arterial injections.
- For GBCAs, administration in at-risk patients requires a thorough risk-benefit analysis, consideration of alternative agents, and dose limitation to 0.1 mmol Gd/kg.
Implications:
- Healthcare providers must be aware of CIN risk factors and appropriate hydration protocols for iodinated contrast agents.
- Understanding NSF diagnostic criteria, GBCA classification, and contraindications is crucial for safe GBCA use.
- Converging recommendations from US and European agencies aim to standardize and improve patient safety regarding contrast agent administration.
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