Yoshito Tsushima1, Tsuneo Ishiguchi2, Takamichi Murakami3, Hiromitsu Hayashi4, Katsumi Hayakawa5, Kunihiko Fukuda6, Yukunori Korogi7, Hideharu Sugimoto8, Yasuo Takehara9, Yoshifumi Narumi10, Yasuaki Arai11, Ryohei Kuwatsuru12, Kengo Yoshimitsu13, Kazuo Awai14, Masayuki Kanematsu15, Ryo Takagi4. 1. Department of Diagnostic Radiology and Nuclear Medicine, Gunma University Graduate School of Medicine, 3-39-22 Showa, Maebashi, Gunma, 373-8511, Japan. tsushima.rad.gunma@gmail.com. 2. Department of Radiology, Aichi Medical University, Nagakute, Aichi, Japan. 3. Department of Radiology, Kinki University, Faculty of Medicine, Osaka, Japan. 4. Department of Radiology, Nippon Medical School, Tokyo, Japan. 5. Department of Radiology, Iwate Prefectural Kamaishi Hospital, Kamaishi, Iwate, Japan. 6. Department of Radiology, The Jikei University School of Medicine, Tokyo, Japan. 7. Department of Radiology, University of Occupational and Environmental Health, Kitakyushu, Fukuoka, Japan. 8. Department of Radiology, Jichi Medical University, Shimotsuke, Tochigi, Japan. 9. Department of Radiology, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan. 10. Department of Radiology, Osaka Medical College, Takatsuki, Osaka, Japan. 11. Department of Diagnostic Radiology, National Cancer Center Hospital, Tokyo, Japan. 12. Department of Radiology, Faculty of Medicine, Juntendo University, Tokyo, Japan. 13. Department of Radiology, Faculty of Medicine, Fukuoka University, Fukuoka, Japan. 14. Department of Diagnostic Radiology, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan. 15. Department of Radiology, Gifu University School of Medicine, Gifu, Gifu, Japan.
Abstract
PURPOSE: To help establish consensus on the safe use of contrast media in Japan. MATERIALS AND METHODS: Questionnaires were sent to accredited teaching hospitals with radiology residency programs. RESULTS: The reply rate was 45.4% (329/724). For contrast-induced nephropathy (CIN), chronic and acute kidney diseases were considered a risk factor in 96.7 and 93.6%, respectively, and dehydration in 73.9%. As preventive actions, intravenous hydration (89.1%) and reduction of iodinated contrast media dose (86.9%) were commonly performed. For nephrogenic systemic fibrosis (NSF), chronic and acute kidney diseases were considered risk factors in 98.5 and 90.6%, respectively, but use of unstable gadolinium-based contrast media was considered a risk factor in only 55.6%. A renal function test was always (63.5% in iodinated; 65.7% in gadolinium) or almost always (23.1; 19.8%) performed, and estimated glomerular filtration rate (eGFR) was the parameter most frequently used (80.8; 82.6%). For the patients with risk factors for acute adverse reaction (AAR), steroid premedication or/and change of contrast medium were frequent preventive actions, but intravenous steroid administration immediately before contrast media use was still performed. CONCLUSION: Our questionnaire survey revealed that preventive actions against CIN were properly performed based on patients' eGFR. Preventive actions against NSF and AAR still lacked consensus.
PURPOSE: To help establish consensus on the safe use of contrast media in Japan. MATERIALS AND METHODS: Questionnaires were sent to accredited teaching hospitals with radiology residency programs. RESULTS: The reply rate was 45.4% (329/724). For contrast-induced nephropathy (CIN), chronic and acute kidney diseases were considered a risk factor in 96.7 and 93.6%, respectively, and dehydration in 73.9%. As preventive actions, intravenous hydration (89.1%) and reduction of iodinated contrast media dose (86.9%) were commonly performed. For nephrogenic systemic fibrosis (NSF), chronic and acute kidney diseases were considered risk factors in 98.5 and 90.6%, respectively, but use of unstable gadolinium-based contrast media was considered a risk factor in only 55.6%. A renal function test was always (63.5% in iodinated; 65.7% in gadolinium) or almost always (23.1; 19.8%) performed, and estimated glomerular filtration rate (eGFR) was the parameter most frequently used (80.8; 82.6%). For the patients with risk factors for acute adverse reaction (AAR), steroid premedication or/and change of contrast medium were frequent preventive actions, but intravenous steroid administration immediately before contrast media use was still performed. CONCLUSION: Our questionnaire survey revealed that preventive actions against CIN were properly performed based on patients' eGFR. Preventive actions against NSF and AAR still lacked consensus.