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Der Nephrologe

, Volume 13, Issue 4, pp 251–261 | Cite as

Nierenfunktion bei kontrastmittelverstärkter Bildgebung

  • M. Jahn
  • S. Becker
  • A. Kribben
Leitthema
  • 309 Downloads

Zusammenfassung

Hintergrund

Die potenziellen Nebenwirkungen kontrastmittelverstärkter Bildgebung stellen Nephrologen und Radiologen im klinischen Alltag immer wieder vor schwierige Entscheidungen.

Ziel der Arbeit

Bewertung der unmittelbar mit der Nierenfunktion in Zusammenhang stehenden Krankheitsbilder kontrastmittelinduziertes akutes Nierenversagen (KM-induziertes ANV) und nephrogene systemische Sklerose (NSF).

Material und Methoden

Literaturrecherche in PubMed und Medline über „Nierenfunktion“ und „Kontrastmittel“, ergänzt durch eigene Erfahrungen.

Ergebnisse

Für das KM-induzierte ANV erfolgt derzeit eine klinische Neubewertung, die NSF tritt unter bestimmten präventiven Maßnahmen und enger Indikationsstellung aktuell nicht mehr auf.

Diskussion

Nach aktueller Studienlage wurde das klinische Risiko eines KM-induzierten ANV lange Zeit überschätzt und sollte keinesfalls eine KM-Gabe verhindern, wenn es keine gleichwertigen diagnostischen Alternativen gibt. Die wirksamste Prophylaxe bleibt die Vermeidung überflüssiger KM-Gaben.

Schlüsselwörter

Kontrastmittelinduziertes akutes Nierenversagen Kontrastmittelinduzierte Nephropathie Nephrogene systemische Fibrose Computertomographie Magnetresonanztomographie 

Kidney function in contrast media-enhanced imaging

Abstract

Background

The potential adverse reactions to contrast media-enhanced imaging regularly offer challenges in decision-making for nephrologists and radiologists.

Objective

The clinical pictures of contrast media-induced acute kidney injury (CI-AKI) and nephrogenic systemic fibrosis (NSF) were evaluated, which are both caused by contrast media and closely linked to the kidney function.

Material and methods

The literature in PubMed and Medline was searched for the terms “kidney function” and “contrast media” and complemented by our own experiences.

Results

While there is an ongoing re-evaluation of the clinical relevance of CI-AKI, no new cases of NSF have recently been reported under consideration of certain preventive interventions and very restricted use of gadolinium-based contrast agents.

Conclusion

Considering the results of the latest clinical research, the potential risk of CI-AKI has been overestimated for a long time and should no longer outweigh the diagnostic benefit of contrast media-enhanced imaging. Nevertheless, the most effective prophylaxis for CI-AKI is the avoidance of unnecessary administration of contrast media.

Keywords

Contrast-induced acute kidney injury Contrast-induced nephropathy Nephrogrenic fibrosing dermopathy Computed tomography Magnetic resonance imaging 

Notes

Einhaltung ethischer Richtlinien

Interessenkonflikt

M. Jahn, S. Becker und A. Kribben geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren.

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Copyright information

© Springer Medizin Verlag GmbH, ein Teil von Springer Nature 2018

Authors and Affiliations

  1. 1.Klinik für NephrologieUniversitätsklinikum Essen, Universität Duisburg EssenEssenDeutschland

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