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European guidelines classify a pre-existing decreased kidney function to be a risk factor of contrast-induced nephropathy in the following cases: [5]. Estimated glomerular filtration rate (eGFR) < 45 ml/min/1.73 m 2 of body surface area before intra-arterial administration with first-pass renal exposure (not passing lungs or peripheral circulation before kidneys), or in the intensive care unit
impaired kidney function is the major risk factor Nephrogenic systemic fibrosis is a rare syndrome that involves fibrosis of the skin, joints, eyes, and internal organs. NSF is caused by exposure to gadolinium in gadolinium-based MRI contrast agents (GBCAs) in patients with impaired kidney function.
Retrograde pyelography is generally done when an intravenous excretory study (intravenous pyelogram or contrast CT scan) cannot be done because of renal disease or allergy to intravenous contrast. Relative contraindications include the presence of infected urine, pregnancy (because of radiation), or allergy to the contrast. [ 13 ]
If kidney impairment is found before administration of the contrast, metformin should be withheld for 48 hours following the procedure and until kidney function has returned to normal. [32] Contrast exposure may interfere with subsequent radioiodine treatment, causing unwanted delays in the management of thyroid cancer. [30]
The use of Gd 3+ chelates in persons with acute or chronic kidney disease can cause nephrogenic systemic fibrosis (NSF), [17] [18] [19] a rare but severe systemic disease resembling scleromyxedema and to some extent scleroderma. It may occur months after contrast injection. [20]
Contrast-enhanced ultrasound is regarded as safe in adults, comparable to the safety of MRI contrast agents, and better than radiocontrast agents used in contrast CT scans. The more limited safety data in children suggests that such use is as safe as in the adult population.
Iodinated contrast contains iodine.It is the main type of radiocontrast used for intravenous administration.Iodine has a particular advantage as a contrast agent for radiography because its innermost electron ("k-shell") binding energy is 33.2 keV, similar to the average energy of x-rays used in diagnostic radiography.
Other side effects include itchiness, kidney problems, low blood pressure, and allergic reactions. [1] It is not recommended in people who have an iodine allergy. [1] Diatrizoate is an iodinated ionic radiocontrast agent with high osmolality. [2] Diatrizoate was approved for medical use in the United States in 1954. [4]