[Kidney function in contrast media-enhanced imaging]

Radiologe. 2019 May;59(5):425-434. doi: 10.1007/s00117-019-0529-2.
[Article in German]

Abstract

Background: The potential adverse reactions to contrast media-enhanced imaging regularly offer challenges in decision-making for nephrologists and radiologists.

Objective: The clinical pictures of contrast media-induced acute kidney injury (CI-AKI) and nephrogenic systemic fibrosis (NSF) were evaluated, which are both caused by contrast media and closely linked to the kidney function.

Material and methods: The literature in PubMed and Medline was searched for the terms "kidney function" and "contrast media" and complemented by our own experiences.

Results: While there is an ongoing re-evaluation of the clinical relevance of CI-AKI, no new cases of NSF have recently been reported under consideration of certain preventive interventions and very restricted use of gadolinium-based contrast agents.

Conclusion: Considering the results of the latest clinical research, the potential risk of CI-AKI has been overestimated for a long time and should no longer outweigh the diagnostic benefit of contrast media-enhanced imaging. Nevertheless, the most effective prophylaxis for CI-AKI is the avoidance of unnecessary administration of contrast media.

Keywords: Computed tomography; Contrast-induced acute kidney injury; Contrast-induced nephropathy; Magnetic resonance imaging; Nephrogrenic fibrosing dermopathy.

Publication types

  • Review

MeSH terms

  • Contrast Media*
  • Gadolinium
  • Humans
  • Magnetic Resonance Imaging
  • Nephrogenic Fibrosing Dermopathy* / diagnostic imaging
  • Risk Factors
  • Urologic Diseases*

Substances

  • Contrast Media
  • Gadolinium