title: Contrast induced nephropathy: updated ESUR Contrast Media Safety Committee guidelines.
abstract: OBJECTIVE
  The Contrast Media Safety Committee (CMSC) of the European Society of Urogenital Radiology (ESUR) has updated its 1999 guidelines on contrast medium-induced nephropathy (CIN).
  
  
  METHODS
  Topics reviewed include the definition of CIN, the choice of contrast medium, the prophylactic measures used to reduce the incidence of CIN, and the management of patients receiving metformin. Key Points • Definition, risk factors and prevention of contrast medium induced nephropathy are reviewed. • CIN risk is lower with intravenous than intra-arterial iodinated contrast medium. • eGFR of 45 ml/min/1.73 m (2) is CIN risk threshold for intravenous contrast medium. • Hydration with either saline or sodium bicarbonate reduces CIN incidence. • Patients with eGFR ≥ 60 ml/min/1.73 m (2) receiving contrast medium can continue metformin normally.
authors.affiliation: S.C. Radiologia Ospedale Maggiore, Piazza Ospitale 1, 34134 Tieste, Italy.
authors.forename: Fulvio
authors.initials: F
authors.lastname: Stacul
authors.forename: Aart J
authors.initials: AJ
authors.lastname: van der Molen
authors.forename: Peter
authors.initials: P
authors.lastname: Reimer
authors.forename: Judith A W
authors.initials: JA
authors.lastname: Webb
authors.forename: Henrik S
authors.initials: HS
authors.lastname: Thomsen
authors.forename: Sameh K
authors.initials: SK
authors.lastname: Morcos
authors.forename: Torsten
authors.initials: T
authors.lastname: Almén
authors.forename: Peter
authors.initials: P
authors.lastname: Aspelin
authors.forename: Marie-France
authors.initials: MF
authors.lastname: Bellin
authors.forename: Olivier
authors.initials: O
authors.lastname: Clement
authors.forename: Gertraud
authors.initials: G
authors.lastname: Heinz-Peer
mesh_terms: D003287:Contrast Media / Q000008:administration & dosage / Q000009:adverse effects*; D017023:Coronary Angiography / Q000009:adverse effects / Q000379:methods*; D005060:Europe; D005260:Female; D005440:Fluid Therapy; D005682:Gadolinium / Q000008:administration & dosage / Q000009:adverse effects*; D005919:Glomerular Filtration Rate; D006333:Heart Failure / Q000000981:diagnostic imaging; D006801:Humans; D007269:Injections, Intra-Arterial; D007275:Injections, Intravenous; D007455:Iodine / Q000008:administration & dosage / Q000009:adverse effects*; D008297:Male; D017410:Practice Guidelines as Topic; D051437:Renal Insufficiency / Q000139:chemically induced* / Q000503:physiopathology / Q000517:prevention & control*; D012307:Risk Factors; D017693:Sodium Bicarbonate / Q000008:administration & dosage; D012965:Sodium Chloride / Q000008:administration & dosage
chemical_list: D003287:Contrast Media; D012965:Sodium Chloride; D017693:Sodium Bicarbonate; D007455:Iodine; D005682:Gadolinium