Contrast media controversies in 2015: imaging patients with renal impairment or risk of contrast reaction.
OBJECTIVE
The incidence and significance of complications related to intravascular contrast material administration have become increasingly controversial. This review will highlight current thinking regarding the imaging of patients with renal impairment and those at risk for an allergiclike contrast reaction.


CONCLUSIONS
The risk of contrast-induced acute kidney injury remains uncertain for patients with an estimated glomerular filtration rate (GFR) less than 45 mL/min/1.73 m(2), but if there is a risk, it is greatest in those with estimated GFR less than 30 mL/min/1.73 m(2). In this population, low-risk gadolinium-based contrast agents appear to have a large safety margin. Corticosteroid prophylaxis remains the standard of care in the United States for patients identified to be at high risk of a contrast reaction, but it has an incomplete mitigating effect on contrast reaction rates and the number needed to treat is large.
1 Department of Radiology, University of Michigan Health System, 1500 E Medical Center Dr, B2-A209P, Ann Arbor, MI 48109-5030.
Matthew S
MS
Davenport
Richard H
RH
Cohan
James H
JH
Ellis
D058186:Acute Kidney Injury / Q000139:chemically induced* / Q000453:epidemiology* / Q000517:prevention & control; D003287:Contrast Media; D064420:Drug-Related Side Effects and Adverse Reactions / Q000453:epidemiology* / Q000517:prevention & control; D019317:Evidence-Based Medicine; D005682:Gadolinium; D006801:Humans; D015994:Incidence; D015995:Prevalence; D012307:Risk Factors
D003287:Contrast Media; D005682:Gadolinium
contrast; contrast media; contrast-induced acute kidney injury (AKI); contrast-induced nephropathy (CIN); safety