Title |
Iodine-based contrast media, multiple myeloma and monoclonal gammopathies: literature review and ESUR Contrast Media Safety Committee guidelines
|
---|---|
Published in |
European Radiology, August 2017
|
DOI | 10.1007/s00330-017-5023-5 |
Pubmed ID | |
Authors |
Fulvio Stacul, Michele Bertolotto, Henrik S. Thomsen, Gabriele Pozzato, Donatella Ugolini, Marie-France Bellin, Georg Bongartz, Olivier Clement, Gertraud Heinz-Peer, Aart van der Molen, Peter Reimer, Judith A. W. Webb, on behalf of the ESUR Contrast Media Safety Committee |
Abstract |
Many radiologists and clinicians still consider multiple myeloma (MM) and monoclonal gammopathies (MG) a contraindication for using iodine-based contrast media. The ESUR Contrast Media Safety Committee performed a systematic review of the incidence of post-contrast acute kidney injury (PC-AKI) in these patients. A systematic search in Medline and Scopus databases was performed for renal function deterioration studies in patients with MM or MG following administration of iodine-based contrast media. Data collection and analysis were performed according to the PRISMA statement 2009. Eligibility criteria and methods of analysis were specified in advance. Cohort and case-control studies reporting changes in renal function were included. Thirteen studies were selected that reported 824 iodine-based contrast medium administrations in 642 patients with MM or MG, in which 12 unconfounded cases of PC-AKI were found (1.6 %). The majority of patients had intravenous urography with high osmolality ionic contrast media after preparatory dehydration and purgation. MM and MG alone are not risk factors for PC-AKI. However, the risk of PC-AKI may become significant in dehydrated patients with impaired renal function. Hypercalcaemia may increase the risk of kidney damage, and should be corrected before contrast medium administration. Assessment for Bence-Jones proteinuria is not necessary. • Monoclonal gammopathies including multiple myeloma are a large spectrum of disorders. • In monoclonal gammopathy with normal renal function, PC-AKI risk is not increased. • Renal function is often reduced in myeloma, increasing the risk of PC-AKI. • Correction of hypercalcaemia is necessary in myeloma before iodine-based contrast medium administration. • Bence-Jones proteinuria assessment in myeloma is unnecessary before iodine-based contrast medium administration. |
X Demographics
Geographical breakdown
Country | Count | As % |
---|---|---|
United States | 2 | 25% |
Brazil | 1 | 13% |
France | 1 | 13% |
Unknown | 4 | 50% |
Demographic breakdown
Type | Count | As % |
---|---|---|
Members of the public | 6 | 75% |
Practitioners (doctors, other healthcare professionals) | 1 | 13% |
Scientists | 1 | 13% |
Mendeley readers
Geographical breakdown
Country | Count | As % |
---|---|---|
Unknown | 71 | 100% |
Demographic breakdown
Readers by professional status | Count | As % |
---|---|---|
Other | 13 | 18% |
Student > Ph. D. Student | 8 | 11% |
Student > Postgraduate | 7 | 10% |
Researcher | 5 | 7% |
Student > Bachelor | 5 | 7% |
Other | 16 | 23% |
Unknown | 17 | 24% |
Readers by discipline | Count | As % |
---|---|---|
Medicine and Dentistry | 32 | 45% |
Nursing and Health Professions | 5 | 7% |
Biochemistry, Genetics and Molecular Biology | 3 | 4% |
Pharmacology, Toxicology and Pharmaceutical Science | 3 | 4% |
Mathematics | 1 | 1% |
Other | 5 | 7% |
Unknown | 22 | 31% |