Kidney and contrast media: Common viewpoint of the French Nephrology societies (SFNDT, FIRN, CJN) and the French Radiological Society (SFR) following ESUR guidelines

Contrast medium administration is classically considered to cause or worsen kidney failure, but recent data may moderate this assertion. The European Society of Urogenital Radiology recently published guidelines re-evaluating the precautions before administering contrast media. Kidney injury does not constitute a contra-indication to the administration of iodinated contrast medium, as long as the benefit-risk ratio justifies it. Intravenous hydration with 0.9% NaCl or 1.4% sodium bicarbonate is the only validated measure for the prevention of post-iodine contrast nephropathy. This is necessary for intravenous or intra-arterial administration of iodinated contrast agent without first renal pass when the glomerular filtration rate is less than 30 mL/min/1.73 m(2), for intra-arterial administration of iodinated contrast agent with first renal passage when the glomerular filtration rate is less than 45 mL/min/1.73 m(2), or in patients with acute renal failure. The use of iodinated contrast medium should allow the carrying out of relevant examinations based on an analysis of the benefit-risk ratio and the implementation of measures to prevent toxicity when necessary. (C) 2021 Societe francaise de radiologie. Published by Elsevier Masson SAS. All rights reserved.

Automated summary

Recent data may moderate the classical notion that contrast medium administration causes or worsens kidney failure. Guidelines have been re-evaluated to allow the administration of iodinated contrast medium under certain conditions where benefit-risk ratio justifies it. Intravenous hydration with 0.9% NaCl or 1.4% sodium bicarbonate is the validated measure for prevention of post-iodine contrast nephropathy.