“Contrast agents are much less nephrotoxic than previously thought”, said Aart van der the current ESUR Contrast Media Safety Committee (CMSC) guideline. Renal adverse reactions to gadolinium-based contrast agents B How long should there be between two iodine-based contrast media injections for routine. The Contrast Media Safety Committee of the European Society of Urogenital Radiology is proud to present the 10th version of its Contrast Agent Guidelines.

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ESUR Update 2018

For abdominal examinations, enhanced CT should be done before enhanced MR. Patients with diabetes mellitus taking metformin. The patient should discuss with the doctor whether the breast milk should gidelines discarded in the 24 hours after contrast medium. The link between nephrogenic systemic fibrosis NSF and gadolinium-based contrast agents was recognized in Gadolinium-based contrast agent The need for hemodialysis should be discussed with the referring physician.

Please send me the monthly newsletter. This differentiation is important for patient stratification: Intravenous IV contrast reaches the renal arteries after passing the right heart and the pulmonary circulation and is thus diluted. Since our first guidelines were published, more than Patient with a history of: Less optimal injection sites including lower limb and small distal veins. Risk factors for skin reactions: In which patients should serum-creatinine be measured before contrast medium administration?

Gadolinium-based contrast agent Correlation of time of the contrast agent injection with the hemodialysis session is recommended. The validity is then only seven days.


In children, the revised Schwartz formula is recommended to calculate eGFR. A suitable protocol is intravenous normal saline, 1.

More severe acute reactions are rare and are similar to those after iodine and gadolinium-based agents see 1. Renal function assessment by questionnaire should be used if serum creatinine is not measured. Hospitals need to provide optimal nephrologic care in these patients in the first place. Can iodine- and gadolinium-based contrast agents safely be given on the same day for routine examinations?

Supportive treatment including observation.

ESUR Guidelines on Contrast Media – European Society of Urogenital Radiology

I confirm that I am a Healthcare Professional. Metformin is contraindicated and iodine-based contrast media should be avoided. Previous acute reaction to gadolinium-based contrast agent.

Consider the use of premedication. Measure eGFR within 48 hours and restart metformin if renal function has not changed significantly.

ESUR Guidelines :

Measurement of renal function B. Continue preventive hydration if appropriate see protocols above. Type and severity of reactions. See renal adverse reactions see 2. No pharmacological prophylaxis with renal vasodilators, receptor antagonists of endogenous vasoactive mediators or cytoprotective drugs has yet been shown to offer consistent protection guidelnies contrast induced nephropathy.

Consider an alternative test not requiring an iodine-based contrast agent. Most skin reactions are conntrast to moderate and self-limiting. Questionnaires to be completed by clinicians referring patients for examinations using iodine- or gadolinium-based contrast media. High osmolality ionic contrast gujdelines.


Refer to renal adverse reactions section 2. Bone, red blood cell labelling. Multiple contrast medium injections within hours. Effect of iodinated contrast media on thyroid function in adults. It provides the rationale for the guidelines in this booklet. Patients not at increased risk.

European Society of Urogenital Radiology

No additional precautions are necessary for the fetus or neonate. This counts as second pass renal exposure. After the procedure, the patient should be monitored for signs of lactic acidosis. The risk of reaction is not related to the osmolality of the contrast agent: Serum creatinine eGFR measurement and clinical assessment of patient before administration: Isotope imaging of the thyroid should be avoided for two months after iodine-based contrast medium injection.

March Henrik S. Extra hemodialysis session to remove contrast medium is unnecessary. Late adverse reactions to intravascular iodine- based contrast media: Patients with diabetes mellitus taking metformin B. Do not perform non-emergency biochemical analysis of blood and urine collected in the 24 hours after contrast medium injection. Symptomatic and similar to the management of other drug-induced skin reactions e. Extra hemodialysis session to remove contrast agent as soon as possible after it has been administered is recommended.

Powered By T3 Framework. Renal adverse reactions to gadolinium-based contrast agents.