Contrast induced-acute kidney injury following peripheral angiography with carbon dioxide versus iodinated contrast media: A meta-analysis and systematic review of current literature

2017 ◽  
Vol 90 (3) ◽  
pp. 437-448 ◽  
Author(s):  
Saad S. Ghumman ◽  
Jonathan Weinerman ◽  
Aazib Khan ◽  
Mubeen S. Cheema ◽  
Marlene Garcia ◽  
...  
Keyword(s):  
Carbon Dioxide ◽  
Systematic Review ◽  
Acute Kidney Injury ◽  
Contrast Media ◽  
Current Literature ◽  
Meta Analysis ◽  
Kidney Injury ◽  
Iodinated Contrast Media ◽  
Peripheral Angiography ◽  
Iodinated Contrast

scholarly journals Iodinated contrast medium: Is there a re(n)al problem? A clinical vignette-based review

Critical Care ◽  
2020 ◽  
Vol 24 (1) ◽  
Author(s):  
Karim Lakhal ◽  
Stephan Ehrmann ◽  
Vincent Robert-Edan
Keyword(s):  
Acute Kidney Injury ◽  
Contrast Media ◽  
Kidney Injury ◽  
Case Vignette ◽  
Iodinated Contrast Media ◽  
Iodinated Contrast Medium ◽  
Iodinated Contrast ◽  
Prophylactic Measures ◽  
Indirect Consequence ◽  
Toxic Potential

Abstract As we were taught, for decades, that iodinated contrast-induced acute kidney injury should be dreaded, considerable efforts were made to find out effective measures in mitigating the renal risk of iodinated contrast media. Imaging procedures were frequently either downgraded (unenhanced imaging) or deferred as clinicians felt that the renal risk pertaining to contrast administration outweighed the benefits of an enhanced imaging. However, could we have missed the point? Among the abundant literature about iodinated contrast-associated acute kidney injury, recent meaningful advances may help sort out facts from false beliefs. Hence, there is increasing evidence that the nephrotoxicity directly attributable to modern iodinated CM has been exaggerated. Failure to demonstrate a clear benefit from most of the tested prophylactic measures might be an indirect consequence. However, the toxic potential of iodinated contrast media is well established experimentally and should not be overlooked completely when making clinical decisions. We herein review these advances in disease and pathophysiologic understanding and the associated clinical crossroads through a typical case vignette in the critical care setting.

Iodine contrast prior to or during pregnancy and neonatal thyroid function: a systematic review

2021 ◽  
Vol 184 (1) ◽  
pp. 189-198 ◽  
Author(s):  
Nienke van Welie ◽  
Maite Portela ◽  
Kim Dreyer ◽  
Linda J Schoonmade ◽  
Madelon van Wely ◽  
...  
Keyword(s):  
Systematic Review ◽  
Contrast Media ◽  
Thyroid Function ◽  
Thyroid Dysfunction ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Iodinated Contrast Media ◽  
Iodinated Contrast ◽  
Increased Risk ◽  
Neonatal Thyroid Function

Objective Thyroid dysfunction is a known side effect of iodinated contrast media. There is some evidence to suggest that iodinated contrast media administered to pregnant women may cause thyroid dysfunction not only in themselves but also in their offspring. Here, we systematically evaluated literature on the use of iodinated contrast media prior to or during pregnancy on the offspring’s thyroid function. Design Systematic review of published literature. Materials and methods Relevant studies were identified by PubMed, EMBASE and The Cochrane Library up to June 5, 2020. All study designs, reporting on the foetal or neonatal thyroid function after exposure to iodinated contrast media prior to or during pregnancy, were included. We undertook random effects meta-analysis and pooled the estimates as proportions with 95% CIs. Results We identified 402 articles, of which 26 were included. Six studies reported (n = 369) on exposure to iodinated contrast media prior to pregnancy by hysterosalpingography and 20 studies (n = 670) on exposure to these media during pregnancy by amniofetography, urography or CT. There was low to high risk of bias. The proportion of (transient) neonatal thyroid dysfunction was 0.0% (95% CI: 0.0–2.9% based on 3 studies) for hysterosalpingography, 2.25% (95% CI: 0.03–6.55% based on 2 studies) for amniofetography and 0.0% (95% CI: 0.0–0.02% based on 5 studies) for CT. There was a tendency towards an increased risk of thyroid dysfunction with higher amounts of contrast used. Conclusions Exposure to iodinated contrast media prior to or during pregnancy may increase the risk of thyroid dysfunction in offspring. We recommend keeping the amount of contrast used as low as possible.

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