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Review
. 2020 Mar;5(2):e000618.
doi: 10.1136/esmoopen-2019-000618.

Acute kidney injury from contrast-enhanced CT procedures in patients with cancer: white paper to highlight its clinical relevance and discuss applicable preventive strategies

Laura Cosmai  1 , Camillo Porta  2   3 , Carmelo Privitera  4 , Loreto Gesualdo  5 , Giuseppe Procopio  6 , Stefania Gori  7 , Andrea Laghi  8
Affiliations
Review

Acute kidney injury from contrast-enhanced CT procedures in patients with cancer: white paper to highlight its clinical relevance and discuss applicable preventive strategies

Laura Cosmai et al. ESMO Open. 2020 Mar.

Abstract

Patients with cancer are subjected to several imaging examinations which frequently require the administration of contrast medium (CM). However, it has been estimated that acute kidney injury (AKI) due to the injection of iodinated CM accounts for 11% of all cases of AKI, and it is reported in up to 2% of all CT examinations. Remarkably, the risks of developing AKI are increased in the elderly, in patients with chronic kidney disease or diabetes, and with dehydration or administration of nephrotoxic chemotherapeutics. Given the common occurrence of postcontrast acute kidney injury (PC-AKI) in clinical practice, primary care physicians and all specialists involved in managing patients with cancer should be aware of the strategies to reduce the risk of this event. In 2018, a panel of four experts from the specialties of radiology, oncology and nephrology were speakers at the annual meeting of the Italian Society of Medical Radiology (Società Italiana di Radiologia Medica e Interventistica), with the aim of commenting on existing evidence and providing their experience on the incidence and management of PC-AKI in patients with cancer. The discussion represented the basis for this white paper, which is intended to be a practical guide organised by statements describing methods to reduce renal injury risks related to CM-enhanced CT examinations in patients with cancer.

Keywords: acute renal injury; cancer; contrast medium.

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Conflict of interest statement

Competing interests: LG, CPo, LC and AL acted as speakers and/or consultants for GE Healthcare. GE Healthcare supported the meeting, which led to this paper.

Figures

Figure 1
Figure 1
Algorithm for the prevention of acute kidney injury: protocol for CT diagnostics. CM, contrast medium.
See this image and copyright information in PMC

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