Department of Translational Medicine, Division of Medical Radiology, University of Lund, Malmö, Sweden.
Division of Medical Imaging and Technology, Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institute/Karolinska University Hospital, Stockholm, Sweden.
Acta Radiol. 2023 May;64(5):1859-1864. doi: 10.1177/02841851231151511. Epub 2023 Feb 7.
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/1.73m 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.
瑞典泌尿放射学会修订了关于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会和美国放射学会相比，他们更加谨慎，因为在中度至重度肾损伤患者中，CI-AKI 的实际风险仍然不确定，这是因为缺乏前瞻性对照研究，主要基于低级别证据的回顾性倾向评分匹配研究。另一个不确定因素是肾小球滤过率（GFR）估计方程的不精确性。然而，随机水化研究表明，对于 GFR 在 30-44 或 45-59 mL/min/1.73m 范围内的门诊患者，联合多种危险因素，CI-AKI 的上限风险约为 5%。除了 GFR 限制外，该指南还包括以克碘/ GFR 比值表示的全身造影剂暴露限制。
