By H.S. Thomsen
In 1994 the ecu Society of Urogenital Radiology (ESUR) arrange a committee to contemplate the protection of the distinction media utilized in radiology departments. due to the fact then, the committee has puzzled contributors, reviewed the literature, proposed directions, and mentioned those proposals with individuals on the annual symposia on urogenital radiology. This ebook represents the outcome of this tough paintings. It comprises the entire agreed directions, up-to-date whilst useful, and thereby comprehensively covers the various diversified questions of safety in terms of the various distinction media: barium distinction media, iodinated distinction media, MR distinction media (both gadolinium-based extracellular and organ-specific) and ultrasound distinction media. The prevention and therapy of either acute and behind schedule non-renal adversarial reactions in addition to the renal hostile reactions are lined intimately. The inclusion of all of the ESUR guidance inside one e-book will supply a useful, precise and exceptional resource.
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The non-selective adenosine receptor antagonist, theophylline, has also been advocated to reduce the risk of contrast medium nephrotoxicity. Adenosine is an important intra-renal mediator, which can induce a decrease in the glomerular filtration rate through vasoconstriction of the afferent arterioles and contraction of the mesangial cells of the glomeruli (Oldroyd et al. 2000). 3 Pharmacological Manipulation Calcium channel blockers prevent the influx of calcium ions through voltage-operated channels, so causing a vasorelaxant effect in all vascular beds including the kidney.
4 Renal Handling of Contrast Media After intravascular administration contrast medium molecules move across capillary membranes (except an intact blood–brain barrier) into the interstitial, extracellular space. Reverse movement from the extracellular space into the intravascular compartment occurs and a state of equilibrium is generally reached within 2 h. Continuous elimination through the glomeruli also occurs. Less than 1% is excreted extrarenally in patients with normal renal function (Thomsen et al.
1999). 5 mg/dl)] have minimal risk (Rudnick et al. 1995; McCullough et al. 1989; Parfrey et al. 1989; Thomsen et al. 2005). 2 When Should Serum Creatinine Be Measured? A questionnaire designed to elicit a history of renal disorders as well as additional risk factors for contrast medium induced nephropathy may be used to identify patients with normal serum creatinine in whom blood testing would be unnecessary (Choyke et al. 1998). 4 mg/dl) for men]. 7 mg/dl). There was a strong association between raised serum creatinine values and a history of renal disease, proteinuria, prior kidney surgery, hypertension, gout and diabetes.