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| Professor Norbert Lameire is
Emeritus Professor of Medicine
at the Medical Faculty of Ghent
University. He received his
training in internal medicine and
nephrology at the University
of Ghent, Faculty of Medicine.
He was appointed Professor of
Medicine in 1991 and he became
Chief of the Renal Division at
the University Hospital and was
Chairman of the Department of
Medicine from 1999-2004. He
is Co-Chair of Kidney Disease
Improving Global Outcomes
(KDIGO), a global nephrology
initiative. Professor Lameire
serves on the editorial boards
of many medical societies and
associations; he is Editor-in-Chief of Nephrology, Dialysis,
Transplantation and Acta Clinica
Belgica. His research interests
include both basic research
(renal circulation in experimental
ARF and the peritoneal
circulation) and clinical topics,
including clinical ARF, peritoneal
dialysis, and organisational and
economic aspects of chronic
renal replacement therapy and
transplantation. |
Screening of renal function prior to administration of iodinated contrast medium
Norbert Lameire
Emeritus Professor of Medicine,
University Hospital, Ghent, Belgium
Address for correspondence:
Professor Norbert Lameire
Department of Medicine, University Hospital
185 De Pintelaan, 9000
Ghent, Belgium
Tel: +32 (0)9-240-4402 Fax: +32 (0)9-240-4403
Email: norbert.lameire@ugent.be
Assessment of baseline renal function
Abstract
Renal impairment at baseline (estimated glomerular
filtration rate [eGFR] <60 ml/min/1.73 m2) is the most
important risk marker to predict the risk of contrastinduced
nephropathy (CIN) in patients receiving iodinated
contrast media. A number of strategies have been shown
to be helpful in managing the risk of CIN in patients at
risk of CIN. Hence, it is important to assess renal function
before administration of contrast medium to ensure that
appropriate steps are taken to reduce the risk. Serum
creatinine alone does not provide a reliable measure of
renal function, and thus the National Kidney Foundation
Kidney Disease Outcome Quality Initiative (K/DOQI)
recommends that clinicians should use an eGFR
calculated from the serum creatinine as an index of renal
function. eGFR should be determined prior to contrast
administration, using the abbreviated Modification of
Diet in Renal Disease (MDRD) formula, recommended by
K/DOQI as the preferred equation for the calculation of
eGFR in adults. Where a serum creatinine measurement
or eGFR is not available, a simple survey or questionnaire
can be used before contrast agent administration to
identify patients at higher risk for CIN than the general
population. In emergency situations, where the benefit
of very early imaging outweighs the risk of waiting, the
investigation or procedure can be undertaken without
assessment of renal function.
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