StardRadiology = ressource pédagogique en radiologie
Contrastes iodés et fonction rénale:
Effect of No Prehydration vs Sodium Bicarbonate Prehydration Prior to Contrast-Enhanced Computed Tomography in the Prevention of Postcontrast Acute Kidney Injury in Adults With Chronic Kidney Disease: The Kompas Randomized Clinical Trial. Timal RJ, Kooiman J, Sijpkens YWJ, et al. JAMA Intern Med 2020;180(4):533-541.
Use of Intravenous Iodinated Contrast Media in Patients with Kidney Disease: Consensus Statements from the American College of Radiology and the National Kidney Foundation. Davenport MS, Perazella MA, Yee J, Dillman JR, Fine D, McDonald RJ, Rodby RA, Wang CL, Weinreb JC. Radiology. 2020 Mar;294(3):660-668. doi: 10.1148/radiol.2019192094. Epub 2020 Jan 21.
Prophylactic hydration to protect renal function from intravascular iodinated contrast material in patients at high risk of contrast-induced nephropathy (AMACING): a prospective, randomised, phase 3, controlled, open-label, non-inferiority trial, Lancet online 170221
The AMACING study found no prophylaxis to be non-inferior to prophylactic intravenous hydration in the prevention of contrast-induced nephropathy, as well as cost-saving. Additionally, we noted that hydration by itself sometimes leads to complications. This is a substantial problem, considering the 6–12 million high-risk patients that undergo procedures with intravascular iodinated contrast administration every year worldwide. Based on these findings and assuming optimal contrast media administration, withholding prophylaxis for high-risk patients with eGFR higher than 29 mL per min/1·73 m2 might be considered without compromising patient safety.
Conclusion: In the largest well-controlled study of acute kidney injury following contrast administration in the ED to date, intravenous contrast was not associated with an increased frequency of acute kidney injury.
Conclusion: We found no significant differences in our principal study outcomes between patients receiving contrast-enhanced CT versus those receiving noncontrast CT. Given similar frequencies of acute kidney injury in patients receiving noncontrast CT, other patient- and illness-level factors, rather than the use of contrast material, likely contribute to the development of acute kidney injury.
Irradiation liée aux examens radiologiques courants
Performance of Low-Dose Perfusion Scintigraphy and CT Pulmonary Angiography for Pulmonary Embolism in Pregnancy, Sheen JJ et al. Chest. January 2018Volume 153, Issue 1, Pages 152–16. doi: 10.1016/j.chest.2017.08.005.
Risque néoplasie post-CT
Site XRayrisk.com avec calculateur du risque en fonction de l'examen
Cancer risk in 680 000 people exposed to computed tomography scans in childhood or adolescence: datalinkage study of 11 million Australians, BMJ 2013;346:f2360 doi: 10.1136/bmj.f2360 (Published 22 May 2013)