Guideline to Use Gadolinium-Based Contrast Agents at Kyoto University Hospital

Guideline to use gadolinium-based contrast agents (GBCAs) to prevent nephrogenic systemic fibrosis (NSF) at Kyoto University Hospital is presented. This guideline is basically the same as the one issued by the joint committee of the Japan Radiological Society and Japanese Society of Nephrology. In the guideline of the joint committee of Japan Radiological Society and Japanese Society of Nephrology, it is described that GBCAs should be used only when they are indispensable for adequate diagnosis regardless of renal function. In this guideline. it is also described that use of GBCAs should be decided after carefully weighing the risks and benefits for patients with estimated glomerular filtration rate (eGFR) 30-60 mL/min/1.73 m(2), and that use of the smallest possible amount of GBCA is necessary even for patients whose eGFR is greater than 60 mL/min/1.73 m(2). The guideline of Kyoto University Hospital includes regulations for patients who underwent or are waiting for liver transplantations, because patients with liver transplantations are reported to have higher risk for NSF and because several hepatic transplantation surgeries are performed at our hospital. Our guideline also regulates the use for neonates or infants less than I year old, because of their immature renal function.