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[Non-iodinated contrast media nephrotoxicity].

Nicolas Janus1, Vincent Launay-Vacher1, Gilbert Deray1

  • 1Service Icar, hôpital de la Pitié-Salpêtrière, 83, boulevard de l'Hôpital, 75013 Paris, France; Service de néphrologie, hôpital de la Pitié-Salpêtrière, 83, boulevard de l'Hôpital, 75013 Paris, France.

Nephrologie & Therapeutique
|October 11, 2018
PubMed
Summary

Gadolinium-based contrast agents, while safer than iodinated contrast media for kidney health, still pose risks like nephrogenic systemic fibrosis. Understanding these risks is crucial for safe patient care in radiology.

Keywords:
Contrast mediaFibrose systémique néphrogéniqueGadoliniumInsuffisance rénaleNephrogenic systemic fibrosisProduits de contrasteRecommandationsRecommendationsRenal failureToxicityToxicité

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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.