Use of iodinated and gadolinium-based contrast media in patients with chronic kidney disease: Consensus statements from nephrologists, cardiologists, and radiologists at National Taiwan University Hospital.
Journal
Journal of the Formosan Medical Association
Journal Volume
125
Journal Issue
3
Start Page
261
End Page
267
ISSN
0929-6646
Date Issued
2026
Author(s)
Wang, Kuan-Chieh
Lin, Li-Chun
Chang, Yu-Ching
Luo, Pei-Jui
Chen, Yu-Ching
Abstract
Contrast media are essential agents that enhance the diagnostic capabilities of imaging studies, such as computed tomography and magnetic resonance imaging. However, concerns regarding the risk of adverse events have led to cautious use in patients with chronic kidney disease. A multidisciplinary review by nephrologists, cardiologists, and radiologists at National Taiwan University Hospital examined evidence linking iodinated contrast media and gadolinium-based contrast agents with acute kidney injury and nephrogenic systemic fibrosis. The consensus is that the risk of iodinated contrast-induced acute kidney injury is minimal in patients with an estimated glomerular filtration rate greater than 30 mL/min/1.73 m. Preventive strategies, including hydration with 0.9% saline and limiting contrast volume, may further reduce acute kidney injury risk in susceptible individuals. For nephrogenic systemic fibrosis, the risk is negligible with group II gadolinium-based contrast agents, even in patients with advanced chronic kidney disease or those on dialysis. The panel concludes that the use of iodinated contrast media or group II gadolinium-based contrast agents should not be postponed in chronic kidney disease patients when clinically significant imaging studies are required.
Subjects
Acute kidney injury
Chronic kidney disease
Contrast medium
Nephrogenic systemic fibrosis
SDGs
Publisher
Elsevier B.V.
Type
journal article