Safety of intravenous gadolinium (Gd-BOPTA) infusion in patients with renal insufficiency

Townsend, Raymond R.; Cohen, Debbie L.; Katholi, Richard E.; Swan, Suzanne K.; Davies, Brian E.; Bensel, Kathy; Lambrecht, L.; Parker, John R.

doi:10.1053/ajkd.2000.19836

Cited by 62 publications

(28 citation statements)

References 25 publications

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“…Maintenance of residual kidney function in dialysis patients may influence the choice of radiologic procedure as well as preprocedure strategies to reduce the risk for contrast-induced acute renal failure. Although magnetic resonance imaging with low dosages of gadolinium was thought to be safe in patients with chronic kidney disease, especially when dialysis was used for poststudy gadolinium removal (37,38), there is some concern that sclerosing fibrosing dermopathy in dialysis patients may be associated with gadolinium (39,40). Postimaging dialysis to remove gadolinium in some patients should perhaps be considered.…”

Section: Imaging Studies In Dialysis Patientsmentioning

confidence: 99%

Screening, Diagnosis, and Treatment of Cancer in Long-Term Dialysis Patients

Holley¹

2007

Clinical Journal of the American Society of Nephrology

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Some have suggested that the American Cancer Society guidelines for cancer screening be applied to patients who are on long-term dialysis and have used cancer screening as a means of assessing delivered preventive health care to patients with ESRD. However, cancer screening is effective only when it leads to survival benefit (usually expressed as days of life saved) without incurring high financial costs. Certain cancers such as human papillomavirus-associated cervical and tongue cancer and urologic malignancies are more common among dialysis patients, yet because the expected remaining lifetime of most dialysis patients is shorter than the time lived to develop malignancy, cancer screening in dialysis patients as applied to the general population is ineffective from the perspective of both cost and survival benefit. Cancer screening in dialysis patients is therefore best provided in an individual patient-focused manner. The occurrence, diagnosis, and treatment of cancer as well as issues related to cancer screening in dialysis patients are discussed.

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Section: Imaging Studies In Dialysis Patientsmentioning

confidence: 99%

Screening, Diagnosis, and Treatment of Cancer in Long-Term Dialysis Patients

Holley¹

2007

Clinical Journal of the American Society of Nephrology

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“…This study's results are in agreement with several previous studies that demonstrated the renal safety of gadolinium in patients with and without renal insufficiency. [12][13][14] However, it must be acknowledged that the limitations of these previous studies include small sample size, lack of control groups, inconsistent pretreatment regimens, different GBCA doses and routes of administration, and variable CIN definitions. Our study is the first study that demonstrates the renal safety of the gadolinium agent, gadobenate dimeglumine (MultiHance), in patients with cirrhosis who are awaiting liver transplantation.…”

Section: Discussionmentioning

confidence: 99%

“…Earlier studies support its safety. [12][13][14] However, recent clinical observations report CIN after the administration of GBCA in patients with renal impairment, with an incidence of 3.5%-50%. [15][16][17][18] Inconsistent results stem from heterogeneous study design, different doses, routes of administration of GBCA, various GBCA used, and different CIN definitions.…”

mentioning

confidence: 99%

Renal safety of intravenous gadolinium‐enhanced magnetic resonance imaging in patients awaiting liver transplantation

Shaffer¹,

Parikh²,

Runge³

et al. 2015

Liver Transpl

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Renal dysfunction in cirrhosis carries a high morbidity and mortality. Given the potential risk of contrast-induced nephropathy associated with iodinated intravenous contrast used in computed tomography (CT), alternate contrast modalities for abdominal imaging in liver transplant candidates need to be examined. The purpose of this study was to examine the renal safety of magnetic resonance imaging (MRI) with gadolinium in patients awaiting liver transplantation. The study involved a retrospective analysis of 352 patients of abdominal MRI with low-dose gadobenate dimeglumine (MultiHance) (0.05 mmol/kg) in patients with cirrhosis and without renal replacement therapy at a single center during the period from 2007 to 2013. For each case, serum creatinine before and within a few days after the MRI were compared. In addition, the patients were analyzed for the development of nephrogenic systemic fibrosis (NSF), a reported complication of gadolinium in chronic kidney disease. The pre-MRI serum creatinine values ranged from 0.36 to 4.86 mg/dL, with 70 patients (20%) having values 1.5 mg/dL. A comparison of the pre-and post-MRI serum creatinine values did not demonstrate a clinically significant difference (mean change 5 0.017 mg/dL; P 5 0.38), including those patients with a pre-MRI serum creatinine 1.5 mg/ dL. In addition, no cases of NSF were noted. In conclusion, our findings suggest that MRI with low-dose gadobenate dimeglumine (MultiHance) is a nonnephrotoxic imaging modality in liver transplant candidates, and its use can be cautiously expanded to liver transplant candidates with concomitant renal insufficiency.

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“…lowers the risk of development CIN in patients with preexisting CKD (Aron et al 1989;Gerber et al 1982;Higgins et al 1983;Lufft et al 2002;Lund et al 1984;Rieger et al 2002;Sterner et al 2001;Townsend et al 2000).…”

Section: Adenosine Antagonistsmentioning

confidence: 99%

“…Gadopendate dimeglumine, a gadolinium-based contrast medium, is widely used in magnetic resonance imaging is considered to be an alternative contrast agent for digital subtraction angiography (DSA) (Rieger et al 2002;Townsend et al 2000). Its use in patients with severe renal impairment (mean creatinine concentration 3.6 mg dl À1 ), either alone or with carbon dioxide, was previously thought to be benign and was not noted to be accompanied by any further renal deterioration (Lufft et al 2002;Rieger et al 2002;Townsend et al 2000).…”

Section: Adenosine Antagonistsmentioning

confidence: 99%