静脉内钆基造影剂在肾脏病患者中的应用：美国放射学会和美国国家肾脏基金会的共识声明。
Use of Intravenous Gadolinium-based Contrast Media in Patients with Kidney Disease: Consensus Statements from the American College of Radiology and the National Kidney Foundation.
机构信息
From the American College of Radiology, Reston, Va (J.C.W., C.L.W., R.J.M., J.R.D., M.S.D.); National Kidney Foundation, New York, NY (R.A.R., J.Y., D.F., M.A.P.); Department of Radiology and Biomedical Imaging (J.C.W.) and Department of Internal Medicine, Section of Nephrology (M.A.P.), Yale University School of Medicine, New Haven, Conn; Department of Nephrology, Rush University Medical Center, Chicago, Ill (R.A.R.); Department of Nephrology, Henry Ford Health System, Detroit, Mich (J.Y.); Department of Radiology, University of Washington, Seattle, Wash (C.L.W.); Department of Nephrology, Johns Hopkins University School of Medicine, Baltimore, Md (D.F.); Department of Radiology, Mayo Clinic, Rochester, Minn (R.J.M.); Department of Radiology, Cincinnati Children's Hospital Medical Center at University of Cincinnati College of Medicine, Cincinnati, Ohio (J.R.D.); Departments of Radiology (M.S.D.) and Urology (M.S.D.), Michigan Medicine, 1500 E Medical Center Dr, Room B2 A209P, Ann Arbor, MI 48109-5030; and Michigan Radiology Quality Collaborative, Ann Arbor, Mich (M.S.D.).
出版信息
Radiology. 2021 Jan;298(1):28-35. doi: 10.1148/radiol.2020202903. Epub 2020 Nov 10.
Inaugural consensus statements were developed and endorsed by the American College of Radiology (ACR) and the National Kidney Foundation to improve and standardize the care of patients with kidney disease who have indication(s) to receive ACR-designated group II or group III intravenous gadolinium-based contrast media (GBCM). The risk of nephrogenic systemic fibrosis (NSF) from group II GBCM in patients with advanced kidney disease is thought to be very low (zero events following 4931 administrations to patients with estimated glomerular filtration rate [eGFR] <30 mL/min per 1.73 m; upper bounds of the 95% confidence intervals: 0.07% overall, 0.2% for stage 5D chronic kidney disease [CKD], 0.5% for stage 5 CKD and no dialysis). No unconfounded cases of NSF have been reported for the only available group III GBCM (gadoxetate disodium). Depending on the clinical indication, the potential harms of delaying or withholding group II or group III GBCM for an MRI in a patient with acute kidney injury or eGFR less than 30 mL/min per 1.73 m should be balanced against and may outweigh the risk of NSF. Dialysis initiation or alteration is likely unnecessary based on group II or group III GBCM administration. This article is a simultaneous joint publication in and . The articles are identical except for stylistic changes in keeping with each journal's style. Either version may be used in citing this article.
美国放射学院（ACR）和美国国家肾脏基金会制定并认可了创始共识声明，以改善和规范有接受 ACR 指定的 II 类或 III 类静脉钆基造影剂（GBCM）适应证的肾病患者的治疗。在晚期肾病患者中，使用 II 类 GBCM 发生肾源性系统纤维化（NSF）的风险被认为非常低（4931 例估计肾小球滤过率[eGFR] <30 mL/min/1.73 m 的患者接受治疗，无一例发生 NSF；95%置信区间的上限：总体为 0.07%，5D 期慢性肾脏病[CKD]为 0.2%，5 期 CKD 且未透析为 0.5%）。对于唯一可用的 III 类 GBCM（钆塞酸二钠），尚未报告无混杂因素的 NSF 病例。根据临床适应证，在急性肾损伤或 eGFR 低于 30 mL/min/1.73 m 的患者中，延迟或拒绝使用 II 类或 III 类 GBCM 进行 MRI 检查的潜在危害，应与 NSF 风险相权衡，并且可能超过 NSF 风险。根据 II 类或 III 类 GBCM 的使用情况，可能无需开始或改变透析。本文是在 和 同时联合发表的。除了每个期刊的风格要求的风格变化外，这两篇文章是相同的。在引用本文时，可以使用任何一个版本。
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