To highlight potential adverse effects of contrast agents. •! To produce guidelines on the safe use of contrast media in different clinical Version has until. “Contrast agents are much less nephrotoxic than previously thought”, said Aart van der the current ESUR Contrast Media Safety Committee (CMSC) guideline. It is a great honor for the Contrast Media Safety Committee of the European So- ciety of Urogenital Radiology (ESUR) to present version of its Contrast Media 7. 1. AN OVERVIEW. This overview summarizes some of the most important.

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You can manage or withdraw your consent at any time. We started in and we have on average updated the booklet every 2 to 3 years. Intravenous cholangiographic contrast media should not be given to patients at risk. Guirelines contrast medium Correlation of time of the contrast medium injection with the hemodialysis session is unnecessary.

A late adverse reaction to intravascular iodine-based contrast medium is defined as a reaction which occurs 1 h to 1 week after contrast medium injection.

Use of a versuon injector. Risk factors for skin reactions:. Most injuries are vrsion. It provides the rationale for the guidelines in this booklet.

Use iodine-based water-soluble contrast media and be prepared to treat a reaction. Late adverse reactions to intravascular iodine- based contrast media: Supportive treatment Severe, protracted: General adverse reactions B. Have the drugs and equipment for resuscitation readily available guidwlines 1. Renal adverse reactions to iodine-based contrast media.

Gadolinium-based contrast media are more nephrotoxic than iodine-based contrast media in equivalent X-ray attenuating doses. Keep the patient in the Radiology Department for 30 min after contrast medium injection. Large volume of contrast medium. CMSC guidelines are based on evidence in the literature whenever possible.


An audience member asked whether a multiple myeloma patients really did not need any special care.

Measurement of renal function B. Stop breastfeeding for 24 hours and discard the milk. Known or suspected acute renal failure. All iodine- and gadolinium-based contrast agents can be removed by hemodialysis or peritoneal dialysis.

The guidelines will successively be translated into many major languages — look out for yours! Patch and delayed reading intradermal tests may be useful to confirm a late skin reaction to contrast medium and to study cross- reactivity patterns with other agents. All other topics for which the Committee has prepared guidelines, including: Use preventive hydration before contrast medium administration see ‘Elective examination’ for protocols. Safety of ultrasound contrast agents.

Comments and questions are welcome at the ESUR webpage www.

To reduce the risk. Measure eGFR conrrast 48 hours and restart metformin if renal function has not changed significantly. The incidence is highest after iodine-based contrast agents and lowest after ultrasound agents.

ESUR Update 2018

It is the case in catheter injections in the left heart, the thoracic aorta, the suprarenal abdominal aorta, or directly into the renal arteries. Type and severity of reactions. At risk patients see above. Contrast Media Safety Committee.

Contrast media :

Avoid iodine-based contrast medium injection for at least 24 hours before the isotope study. Drug prophylaxis is generally not recommended.

Last update April 17, Elective Examination Identify patients who require measurement of renal function Determine eGFR or SCr within 7 days of contrast medium administration. The 10 th version of the Guidelines includes updated sections on acute adverse reactions, gadolinium contrast agents and other gadolinium issues, post contrast acute kidney injury PC-AKI and myeloma and contrast media. Use low or iso-osmolar contrast media. Use the lowest dose of contrast medium consistent with a diagnostic result.


Although the contrast agents in current use have been on the market for many years, minor changes occur in their adverse reaction pattern and new observations are reported. Ultrasound contrast media are generally safe.

ESUR guidelines on Contrast Media – B. Renal adverse reactions

Following administration of gadolinium-based agents to the mother during pregnancy, no neonatal tests are necessary. Use of nonionic dimers.

Breast feeding may be continued normally when iodine-based agents are given to the mother. Please send me the monthly newsletter.

However, there is no evidence that hemodialysis protects patients with impaired renal function from post contrast acute kidney oj or nephrogenic systemic fibrosis. Consider an alternative test not requiring an iodine-based contrast agent. No additional precautions are necessary for the fetus or neonate. No pharmacological prophylaxis with renal vasodilators, receptor antagonists of endogenous vasoactive mediators or cytoprotective drugs has yet been shown to offer consistent protection against contrast induced nephropathy.

Patients with diabetes mellitus taking metformin B. Since our first guidelines were published, more than We hope that you like the new booklet, that it is helpful in your practice and that it will benefit all our patients.

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