Contrast-Media-in-Advanced-Cardiovascular-Imaging?

For patients with stable estimated glomerular filtration rate (eGFR) ≥30 mL/min/1.73 m2, the risk of kidney injury from iodinated contrast material is low; however, the risk is uncertain in those with eGFR <30 mL/min/1.73 m2, in those with acute kidney injury, and in those without anuria who are receiving dialysis.

Patients with a prior hypersensitivity reaction to the same class of contrast media (iodine or gadolinium based) are at increased risk of a subsequent hypersensitivity reaction, and this risk can be mitigated by switching agents; iodine-containing substances (e.g., shellfish, topical povidone-iodine) have no cross reactivity with iodinated contrast material.

Group II gadolinium-based contrast agents have minimal risk (0-0.07%) of nephrogenic systemic fibrosis even in patients at higher risk (eGFR <30 mL/min/1.73 m2) with standard doses (≤0.1 mmol/kg); recent consensus statements have deemed kidney function screening optional.