Consensus Report from Oncology Advisory Board Meeting

Strategies for Prevention and Management of CI-AKI and the Role of Contrast in Oncology CT Settings • 27  Assess the risk for CI-AKI in all patients who are considered for a procedure that requires intravascular/intra-arterial administration of iodinated contrast medium (CM). Use eGFR to assess kidney function of the patient.  Use a uniform definition-based on serum creatinine (Cr) and urine output to diagnose AKI.  Use the lowest dose of CM consistent with the diagnostic results.  The incidence of CI-AKI will decrease dramatically when the right volume expansion protocols are implemented.  The recommendation of “nil per os after midnight” before a planned imaging examination should, therefore, be reconsidered.  Metformin needs to be withheld to avoid lactic acidosis, ACE/ARBs may, however, be continued.  Administration of nephrotoxic drugs should be based on the benefit-risk ratio.  Isosmolar contrast media (IOCM) should be preferred over low osmolar contrast media (LOCM) in patients with high risk of CI-AKI. Do’s and Don’ts Before, During, and After Contrast-Based Imaging to Prevent CI-AKI. Do’s and Don’ts