Abstract:
The Swedish Society of Uroradiology has revised their computed tomography (CT) guidelines regarding iodine contrast media-induced acute kidney injury (CI-AKI). They are more cautious compared to the European Society of Urogenital Radiology and the American College of Radiology since the actual risk of CI-AKI remains uncertain in patients with moderate to severe kidney damage due to a lack of prospective controlled studies and mainly based on retrospective propensity score-matched studies with low-grade evidence. Another source of uncertainty is the imprecision of glomerular filtration rate (GFR) estimating equations. However, randomized hydration studies indictae an upper limit risk of CI-AKI of about 5% for outpatients with a GFR in the range of 30-44 or 45-59 mL/min/1.73m2 combined with multiple risk factors. Apart from GFR limits, the guideline also includes limits for systemic contrast medium exposure expressed in gram-iodine/GFR ratio.
摘要:
瑞典Uroradiology学会修订了有关碘造影剂引起的急性肾损伤(CI-AKI)的计算机断层扫描(CT)指南。与欧洲泌尿生殖放射学学会和美国放射学会相比,他们更为谨慎,因为由于缺乏前瞻性对照研究,并且主要基于回顾性倾向评分匹配研究和低级别证据,中度至重度肾损害患者的CI-AKI的实际风险仍不确定。不确定性的另一个来源是肾小球滤过率(GFR)估计方程的不精确性。然而,随机水合研究表明,对于GFR在30-44或45-59mL/min/1.73m2范围内并伴有多种危险因素的门诊患者,CI-AKI的上限风险约为5%.除了GFR限制,该指南还包括以克碘/GFR比值表示的全身造影剂暴露限值.