Radiologists and clinicians should weigh the relative benefits and risks of using IV contrast in patients with eGFRs less than 30 mL/min/1.73 m2, according to a consensus statement.
Withholding prehydration with sodium bicarbonate from patients with CKD stage 3 undergoing nonemergent contrast-enhanced computed tomography does not compromise renal safety, a study found.
The potential diagnostic harms of withholding group II gadolinium-based contrast agents may outweigh the risk of nephrogenic systemic fibrosis in advanced CKD patients, according to investigators.
No patient had a 25% or greater rise in serum creatinine 48 hours after receiving a median 13 mL of contrast for diagnostic coronary angiography, with an additional 13 mL for percutaneous coronary intervention.
Contrast-associated acute kidney injury occurred in 9.5% and 9.1% of patients receiving IV sodium bicarbonate and acetylcysteine, respectively, rates which did not differ significantly from the 8.3% rate among those receiving IV sodium chloride.
In a phase 3 trial, acute kidney injury developed in 13.2% of patients undergoing invasive coronary angiography compared with 5.6% of those undergoing computed tomography angiography.
