Canadian Association of Radiologists consensus guidelines for the prevention of contrast-induced nephropathy : update 2012
Copyright © 2014 Canadian Association of Radiologists. Published by Elsevier Inc. All rights reserved..
PURPOSE: Contrast-induced acute kidney injury or contrast-induced nephropathy (CIN) is a significant complication of intravascular contrast medium (CM). These guidelines are intended as a practical approach to risk stratification and prevention. The major risk factor that predicts CIN is pre-existing chronic kidney disease.
METHODS: Members of the committee represent radiologists and nephrologists across Canada. The previous guidelines were reviewed, and an in-depth up-to-date literature review was carried out.
RESULTS: A serum creatinine level (SCr) should be obtained, and an estimated glomerular filtration rate (eGFR) should be calculated within 6 months in the outpatient who is stable and within 1 week for inpatients and patients who are not stable. Patients with an eGFR of ≥ 60 mL/min have an extremely low risk of CIN. The risk of CIN after intra-arterial CM administration appears be at least twice that after intravenous administration. Fluid volume loading remains the single most important measure, and hydration regimens that use sodium bicarbonate or normal saline solution should be considered for all patients with GFR < 60 mL/min who receive intra-arterial contrast and when GFR < 45 mL/min in patients who receive intravenous contrast. Patients are most at risk for CIN when eGFR < 30 mL/min. Additional preventative measures include the following: avoid dehydration, avoid CM when appropriate, minimize CM volume and frequency, avoid high osmolar CM, and discontinue nephrotoxic medications 48 hours before administration of CM.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2014 |
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| Erschienen: |
2014 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:65 |
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| Enthalten in: |
Canadian Association of Radiologists journal = Journal l'Association canadienne des radiologistes - 65(2014), 2 vom: 13. Mai, Seite 96-105 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Owen, Richard J [VerfasserIn] |
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| Links: |
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| Themen: |
Acute renal failure |
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| Anmerkungen: |
Date Completed 19.06.2014 Date Revised 22.07.2019 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1016/j.carj.2012.11.002 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM235758892 |
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| 500 | |a Date Revised 22.07.2019 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2014 Canadian Association of Radiologists. Published by Elsevier Inc. All rights reserved. | ||
| 520 | |a PURPOSE: Contrast-induced acute kidney injury or contrast-induced nephropathy (CIN) is a significant complication of intravascular contrast medium (CM). These guidelines are intended as a practical approach to risk stratification and prevention. The major risk factor that predicts CIN is pre-existing chronic kidney disease | ||
| 520 | |a METHODS: Members of the committee represent radiologists and nephrologists across Canada. The previous guidelines were reviewed, and an in-depth up-to-date literature review was carried out | ||
| 520 | |a RESULTS: A serum creatinine level (SCr) should be obtained, and an estimated glomerular filtration rate (eGFR) should be calculated within 6 months in the outpatient who is stable and within 1 week for inpatients and patients who are not stable. Patients with an eGFR of ≥ 60 mL/min have an extremely low risk of CIN. The risk of CIN after intra-arterial CM administration appears be at least twice that after intravenous administration. Fluid volume loading remains the single most important measure, and hydration regimens that use sodium bicarbonate or normal saline solution should be considered for all patients with GFR < 60 mL/min who receive intra-arterial contrast and when GFR < 45 mL/min in patients who receive intravenous contrast. Patients are most at risk for CIN when eGFR < 30 mL/min. Additional preventative measures include the following: avoid dehydration, avoid CM when appropriate, minimize CM volume and frequency, avoid high osmolar CM, and discontinue nephrotoxic medications 48 hours before administration of CM | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Practice Guideline | |
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| 650 | 4 | |a Chronic kidney disease | |
| 650 | 4 | |a Contrast-induced acute kidney injury | |
| 650 | 4 | |a Contrast-induced nephropathy | |
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| 700 | 1 | |a Fraser-Hill, Margaret |e verfasserin |4 aut | |
| 700 | 1 | |a Barrett, Brendan J |e verfasserin |4 aut | |
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