Gadolinium-based contrast media may be nephrotoxic even at approved doses.
It is generally believed that gadolinium-based contrast media are not nephrotoxic at the approved doses for MR (<0.3 mmol/kg body weight). Recently, a patient with diabetic nephropathy required dialysis because of anuria 6-7 days after MR angiography with 0.14 mmol/kg body weight gadolinium-DTPA-BMA to assess renal artery stenosis. No special precautions (e.g., hydration) had been taken. The serum creatinine levels had been within 200 and 300 micromol/l for the last 3 years with a very slow increase. This case highlights that gadolinium-based contrast media can cause contrast medium-induced nephropathy even at doses below 0.2 mmol/kg body weight in patients with multiple risk factors.
Thomsen
Henrik S
HS
Department of Diagnostic Radiology 54E2, Copenhagen University Hospital at Herlev, Herlev Ringvej 75, 2730 Herlev, Denmark. heth@herlevhosp.kbhamt.dk
D000368:Aged; D003287:Contrast Media / Q000633:toxicity*; D003928:Diabetic Nephropathies / Q000175:diagnosis; D003937:Diagnosis, Differential; D004305:Dose-Response Relationship, Drug; D005682:Gadolinium / Q000633:toxicity*; D019786:Gadolinium DTPA / Q000633:toxicity*; D006801:Humans; D007677:Kidney Function Tests; D018810:Magnetic Resonance Angiography; D008297:Male; D012078:Renal Artery Obstruction / Q000175:diagnosis*; D051437:Renal Insufficiency / Q000139:chemically induced* / Q000175:diagnosis
D003287:Contrast Media; C064925:gadodiamide; D005682:Gadolinium; D019786:Gadolinium DTPA