European Society of Urogenital Radiology guidelines on contrast media application

Purpose of review The present review covers the European Society of Urogenital Radiology guidelines for safe use of contrast media of importance for referring urologists. Recent findings During the recent years contrast medium-induced nephropathy has become a hot topic. It is of importance to reduce its incidence. First of all, the patients at risk should be identified prior to the administration of a contrast medium, so that appropriate measures can be taken. Before intravenous administration of an iodinated agent but not before gadolinium-based and ultrasound agents, all patients should be questioned about the potential renal dysfunction at the time of referral, and only those who answer affirmative to at least one question should have their serum creatinine level determined. Before intraarterial injection, the serum creatinine should always be measured. In case of an abnormal level, another imaging procedure should be considered. If impossible, hydration should be instituted and administration of nephrotoxic drugs should be stopped. After administration, delayed reactions such as nephrogenic systemic fibrosis, thyreotoxicosis, skin rash, etc. may be seen. Interaction with isotope studies and biochemical analysis occurs too. Summary The awareness regarding the potential adverse reactions due to contrast media and the necessary precautions to be taken are of utmost importance both for radiologists and referring physicians. This is the only way to reduce their incidence.