Abstract
Objectives
The Contrast Media Safety Committee (CMSC) of the European Society of Urogenital Radiology (ESUR) has updated its 2011 guidelines on the prevention of post-contrast acute kidney injury (PC-AKI). The results of the literature review and the recommendations based on it, which were used to prepare the new guidelines, are presented in two papers.
Areas covered in part 2
Topics reviewed include stratification of PC-AKI risk, the need to withdraw nephrotoxic medication, PC-AKI prophylaxis with hydration or drugs, the use of metformin in diabetic patients receiving contrast medium and the need to alter dialysis schedules in patients receiving contrast medium.
Key points
• In CKD, hydration reduces the PC-AKI risk
• Intravenous normal saline and intravenous sodium bicarbonate provide equally effective prophylaxis
• No drugs have been consistently shown to reduce the risk of PC-AKI
• Stop metformin from the time of contrast medium administration if eGFR < 30 ml/min/1.73 m 2
• Dialysis schedules need not change when intravascular contrast medium is given
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