[Non-iodinated contrast media nephrotoxicity]

Area of Science:

• Radiology and Imaging
• Nephrology
• Pharmacology

Background:

• Interventional radiology frequently uses iodinated contrast media, carrying a risk of renal toxicity.
• Gadolinium-based contrast agents (GBCAs) were introduced as a safer alternative, particularly for at-risk patients.
• However, GBCAs also carry nephrotoxicity risks, including nephrogenic systemic fibrosis (NSF).

Purpose of the Study:

• To detail the renal risks associated with gadolinium-based contrast agents.
• To review current European and US health agency recommendations for GBCA use.
• To guide clinicians in evaluating the benefit-risk balance for safe radiological examinations.

Main Methods:

• Review of scientific literature on gadolinium-based contrast agent nephrotoxicity and NSF.
• Analysis of current recommendations from European and US health agencies regarding patient risk stratification.
• Synthesis of best practices for selecting contrast agents based on renal function and GBCA type.

Main Results:

• Gadolinium-based contrast agents are not entirely free from nephrotoxicity and carry the risk of NSF.
• Health agencies have established guidelines to identify patients at risk for NSF based on renal function and GBCA type.
• A clear understanding of GBCA risks and patient-specific factors is essential for informed decision-making.

Conclusions:

• Clinicians must carefully weigh the benefits against the renal risks of GBCAs for each patient.
• Adherence to updated recommendations and best practices is vital to minimize contrast-induced nephrotoxicity and NSF.
• Informed patient selection and monitoring are key to ensuring safe and effective radiological procedures.