To highlight potential adverse effects of contrast agents. •! To produce guidelines on the safe use of contrast media in different clinical Version has until. “Contrast agents are much less nephrotoxic than previously thought”, said Aart van der the current ESUR Contrast Media Safety Committee (CMSC) guideline. It is a great honor for the Contrast Media Safety Committee of the European So- ciety of Urogenital Radiology (ESUR) to present version of its Contrast Media 7. 1. AN OVERVIEW. This overview summarizes some of the most important.
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ESUR Guidelines :
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However, the ESUR guidelines are not only about evidence-based data: I mproving G lobal O utcomes is a global non-profit organization developing evidence-based clinical practice guidelines in kidney disease guidelines for staging acute kidney injury Meria.
Stage 1 is defined as serum creatinine sCr of more than Stages 2 and 3 rarely apply in esru radiology setting. The validity is then only seven days. In hospital inpatietns with diagnosed AKI one to two days are preferable. There is no additional AKI risk in patients with solitary kidneys, kidney transplants, multiple myeloma or monoclonal gammopathy. The risk of AKI is similar for low-osmolar and iso-osmolar contrast agents.
ESUR Update 2018
It is increased for high-osmolar agents and for repeated injections within 48 to 72 hours. Van der Molen made sure to point out the difference in contrast agent concentration entering the kidneys is dependent on the injection site:.
This differentiation is important for patient stratification: In this case, three precautionary steps should be followed:. Oral hydration alone is not recommended.
Their eGFR should be determined within 48 hours. It their renal function has not deteriorated, they should restart metformin. An audience member asked whether a multiple myeloma patients really did not need any special care. Van der Molen answered that care in these patients starts one step before the ESUR guideline kicks in: Hospitals need to provide optimal nephrologic care in these patients in the first place.
If a hospital does this, these patients will not require special precautions. However, dehydration is hard to examine, because there is no sound criteria for it, he added. Van der Molen also stressed that implementing guidelines in his hospital was a joint effort, involving all doctors.
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Already have an account? Versiob update April 17, Some versjon have been adapted, but hydration remains a mainstay in kidney injury prevention. Risk Stratification Van der Molen made sure to point out the difference in contrast agent concentration entering the kidneys is dependent on the injection site: Intravenous IV contrast reaches the renal arteries after passing the right heart and the pulmonary circulation and is thus diluted.
This counts as second pass renal exposure. The effect of intraarterial IA application depends on the injection site: This counts as first pass renal exposure.
Contrast media :
It is the case in catheter injections in the left heart, the thoracic aorta, the suprarenal contrastt aorta, or directly into the renal arteries. In this case, three precautionary steps should be followed: Keep the ratio of iodine dose in gram iodine and absolute GFR below 1.
Pateints with heart failure NYHA or end stage renal failure should get individualized hydration.