Contrast agents in patients on dialysis.
Contrast media are used to enhance the structural and functional information that is provided by imaging methods. They are used particularly in conventional radiographic (X-ray) investigations, but are also used in magnetic resonance imaging (MRI) and increasingly in ultrasound (US). The water-soluble, iodinated, intravascular radiographic agents are commonly used, and in large doses. They are excreted almost exclusively by the kidney and may have nephrotoxic effects. The use of these agents in patients with renal impairment may potentially be problematic. In this article the chemical composition and pharmacokinetics of these contrast agents are reviewed, as are their potentially toxic effects on the heart, neural tissues, kidney, and endothelium. Their safety for use in the patient with end-stage renal disease (ESRD) and those on dialysis is discussed. This aspect is also addressed briefly for the contrast agents used to augment MRI and US.
Dawson
Peter
P
Department of Imaging, University College London Hospitals, United Kingdom. phd728222@aol.com
D003287:Contrast Media / Q000009:adverse effects* / Q000493:pharmacokinetics*; D005260:Female; D006801:Humans; D007668:Kidney / Q000187:drug effects; D007676:Kidney Failure, Chronic / Q000628:therapy*; D007677:Kidney Function Tests; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D011322:Primary Prevention; D011379:Prognosis; D011856:Radiographic Image Enhancement / Q000379:methods*; D006435:Renal Dialysis / Q000009:adverse effects / Q000379:methods*; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index
D003287:Contrast Media