Risk of Gadolinium-Based Contrast Agents in Chronic Kidney Disease—Is Zero Good Enough?

Maripuri, Saugar; Johansen, Kirsten L.

doi:10.1001/jamainternmed.2019.5278

Cited by 7 publications

(6 citation statements)

References 5 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In 2010, the Food and Drug Administration issued a black box warning for all GBCM with the recommendation of kidney function screening before GBCM administration to identify patients with AKI or stage 4 or 5 CKD (29). However, it is now apparent that the risk of NSF varies by GBCM and is extremely low for group II GBCM, even in high-risk patients (3,7,8,29). Based on these updated data, the ACR, European Society of Urogenital Radiology, and Canadian Association of Radiology have issued recommendations liberalizing the administration of group II GBCM in high-risk patients (20,30,31).…”

Section: Is the Risk Of Nsf The Same For All Gbcm?mentioning

confidence: 99%

“…While GBCM-enhanced MRI examinations are preferred over unenhanced examinations for many indications, they may be delayed or denied in patients with impaired kidney function due to concerns of adverse events, including nephrogenic systemic fibrosis (NSF) and nephrotoxicity. However, recommendations about the use of GBCM in patients with kidney disease have evolved and have been inconsistent in clinical practice among radiologists and nephrologists, even within the same institution (3).…”

mentioning

confidence: 99%

See 1 more Smart Citation

Use of Intravenous Gadolinium-based Contrast Media in Patients with Kidney Disease: Consensus Statements from the American College of Radiology and the National Kidney Foundation

Weinreb¹,

Rodby²,

Yee³

et al. 2021

Radiology

134

109

View full text Add to dashboard Cite

Section: Is the Risk Of Nsf The Same For All Gbcm?mentioning

confidence: 99%

mentioning

confidence: 99%

Use of Intravenous Gadolinium-based Contrast Media in Patients with Kidney Disease: Consensus Statements from the American College of Radiology and the National Kidney Foundation

Weinreb¹,

Rodby²,

Yee³

et al. 2021

Radiology

134

109

View full text Add to dashboard Cite

“…Gadolinium-based contrast agents are remarkably safe, with a lower adverse event rate for both allergic type reactions and nephrotoxicity than iodine-based contrast media 68. The RCR recommends the following in patients with chronic renal impairment (in alignment with the European Medicines Agency)69:…”

Section: Cardiovascular Mrimentioning

confidence: 99%

United Kingdom standards for non-invasive cardiac imaging: recommendations from the Imaging Council of the British Cardiovascular Society

Treibel

Kelion

Ingram

et al. 2022

Heart

View full text Add to dashboard Cite

Heart and circulatory diseases affect more than seven million people in the UK. Non-invasive cardiac imaging is a critical element of contemporary cardiology practice. Progressive improvements in technology over the last 20 years have increased diagnostic accuracy in all modalities and led to the incorporation of non-invasive imaging into many standard cardiac clinical care pathways. Cardiac imaging tests are requested by a variety of healthcare practitioners and performed in a range of settings from the most advanced hospitals to local health centres. Imaging is used to detect the presence and consequences of cardiovascular disease, as well as to monitor the response to therapies. The previous UK national imaging strategy statement which brought together all of the non-invasive imaging modalities was published in 2010. The purpose of this document is to collate contemporary standards developed by the modality-specific professional organisations which make up the British Cardiovascular Society Imaging Council, bringing together common and essential recommendations. The development process has been inclusive and iterative. Imaging societies (representing both cardiology and radiology) reviewed and agreed on the initial structure. The final document therefore represents a position, which has been generated inclusively, presents rigorous standards, is applicable to clinical practice and deliverable. This document will be of value to a variety of healthcare professionals including imaging departments, the National Health Service or other organisations, regulatory bodies, commissioners and other purchasers of services, and service users, i.e., patients, and their relatives.

show abstract

“…However, it is now apparent that the risk of NSF varies by GBCM and is extremely low for group II GBCM, even in high-risk patients. 3,7,8,29 Based on these updated data, the ACR, European Society of Urogenital Radiology, and Canadian Association of Radiology have issued recommendations liberalizing the administration of group II GBCM in high-risk patients. 20,30,31 In contrast to the Food and Drug Administration, these organizations do not consider group II GBCM to be contraindicated in high-risk patients and consider kidney function screening prior to use of group II GBCM optional.…”

Section: Should Screening For Kidney Disease Be Used To Identify Patimentioning

confidence: 99%

“…However, recommendations about the use of GBCM in patients with kidney disease have evolved and have been inconsistent in clinical practice among radiologists and nephrologists, even within the same institution. 3 A multidisciplinary group of five radiologists (J.C.W., C.L.W., R.J.M., J.R.D., M.S.D.) and four nephrologists (R.A.R., J.Y., D.F., M.A.P.)…”

mentioning

confidence: 99%

Use of Intravenous Gadolinium-Based Contrast Media in Patients With Kidney Disease: Consensus Statements from the American College of Radiology and the National Kidney Foundation

et al. 2021

View full text Add to dashboard Cite

Inaugural consensus statements were developed and endorsed by the American College of Radiology (ACR) and National Kidney Foundation to improve and standardize the care of patients with kidney disease who have indication(s) to receive ACR-designated group II or group III intravenous gadolinium-based contrast media (GBCM). The risk of nephrogenic systemic fibrosis (NSF) from group II GBCM in patients with advanced kidney disease is thought to be very low (zero events following 4931 administrations to patients with estimated glomerular filtration rate [eGFR] <30 mL/min per 1.73 m 2 ; upper bounds of the 95% confidence intervals: 0.07% overall, 0.2% for stage 5D chronic kidney disease [CKD], 0.5% for stage 5 CKD and no dialysis). No unconfounded cases of NSF have been reported for the only available group III GBCM (gadoxetate disodium). Depending on the clinical indication, the potential harms of delaying or withholding group II or group III GBCM for an MRI in a patient with acute kidney injury or eGFR less than 30 mL/min per 1.73 m 2 should be balanced against and may outweigh the risk of NSF. Dialysis initiation or alteration is likely unnecessary based on group II or group III GBCM administration.

show abstract

Risk of Gadolinium-Based Contrast Agents in Chronic Kidney Disease—Is Zero Good Enough?

Abstract: Incidence of nephrogenic systemic fibrosis using gadobenate dimeglumine in 1423 patients with renal insufficiency compared with gadodiamide.

Cited by 7 publications

References 5 publications

Use of Intravenous Gadolinium-based Contrast Media in Patients with Kidney Disease: Consensus Statements from the American College of Radiology and the National Kidney Foundation

Use of Intravenous Gadolinium-based Contrast Media in Patients with Kidney Disease: Consensus Statements from the American College of Radiology and the National Kidney Foundation

United Kingdom standards for non-invasive cardiac imaging: recommendations from the Imaging Council of the British Cardiovascular Society

Use of Intravenous Gadolinium-Based Contrast Media in Patients With Kidney Disease: Consensus Statements from the American College of Radiology and the National Kidney Foundation

Contact Info

Product

Resources

About