Documento di consenso SIBioC e Società Italiana di Radiologia Medica (SIRM) sulla richiesta di esami di laboratorio per la valutazione del danno renale da mezzi di contrasto = SIBioC-SIRM consensus document on the request of laboratory tests for evaluation of contrast media nephrotoxicity
Articolo
Data di Pubblicazione:
2014
Citazione:
Documento di consenso SIBioC e Società Italiana di Radiologia Medica (SIRM) sulla richiesta di esami di laboratorio per la valutazione del danno renale da mezzi di contrasto = SIBioC-SIRM consensus document on the request of laboratory tests for evaluation of contrast media nephrotoxicity / M. Mussap, M. Graziani, A. Caldini, A. Dolci, G. Merlini. - In: BIOCHIMICA CLINICA. - ISSN 0393-0564. - 38:2(2014 Apr), pp. 140-142.
Abstract:
The contrast media, widely used in imaging diagnostics, show a favorable safety profile. As the presence of pre-existing disease is considered a risk factor for adverse events, patients should be carefully evaluated prior to the procedure. The aim of this consensus document is to recommend appropriate biochemical tests to be performed for an early recognition of individuals at higher risk of contrast media nephrotoxicity. This condition is defined by an increase of serum creatinine concentrations of at least 0.50 mg/dL and/or 25% within 3-4 days from contrast media exposure. The most important risk factor is renal insufficiency [estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m2 or serum creatinine >1.50 mg/dL]. Other risk factors are age >75 years, dehydration, diabetes, heart failure and anemia. Monoclonal gammopathies, multiple myeloma, Waldenström macroglobulinemia and amyloidosis are not considered risk factors per se. On the basis of available guidelines, it is recommended: a) prior to the examination, to measure serum creatinine baseline with a method traceable to the international reference measurement system and report its concentration together with the eGFR using the Chronic Kidney Disease - Epidemiology Collaboration (CKD-EPI) equation; b) for monitoring, to measure serum creatinine more than once calculating the delta from the baseline value: if serum creatinine increases >5%, repeat the test within 48- 72 h. Performing of laboratory tests to exclude the presence of monoclonal gammopathies (i.e., serum protein electrophoresis, Bence Jones protein determination, serum free light chain measurements) is not required.
Tipologia IRIS:
01 - Articolo su periodico
Elenco autori:
M. Mussap, M. Graziani, A. Caldini, A. Dolci, G. Merlini
Link alla scheda completa: