Imaging patients with kidney disease: How do we approach contrast-related toxicity?

Mark A. Perazella, Robert F. Reilly

Research output: Contribution to journalReview article

20 Scopus citations

Abstract

The approach to imaging patients with kidney disease with iodinated radiocontrast and gadolinium-based contrast has changed dramatically in recent times. The complications of these contrast agents, radiocontrast nephropathy and nephrogenic systemic fibrosis, respectively, underlie the changes in the imaging practice used in these patients. Rather than to completely avoid the use of these contrast agents, one must remain judicious in the choice of imaging modality in this group of patients. A prudent approach would be to (1) identify patients at high risk to develop contrast-related complications, (2) use noncontrast-based imaging techniques in these patients, as long as they are suitably diagnostic and safe and (3) if the risk:benefit ratio of the imaging information favors a contrast-based study, then appropriate prophylactic steps and use of contrast agents with the lowest risk of complication should be used after obtaining informed consent. This will allow one to maximize the diagnostic efficiency while also limiting the adverse effects.

Original languageEnglish (US)
Pages (from-to)215-221
Number of pages7
JournalAmerican Journal of the Medical Sciences
Volume341
Issue number3
DOIs
StatePublished - Mar 2011

Keywords

  • Diagnostic imaging
  • Gadolinium
  • Kidney disease
  • Nephrogenic systemic fibrosis
  • Radiocontrast-induced nephropathy

ASJC Scopus subject areas

  • Medicine(all)

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