• Kuan-Chieh Wang, Li-Chun Lin, Szu-Yu Pan, Jenq-Wen Huang, Yu-Ching Chang, Jiun-Yang Chiang, Hsien-Li Kao, Pei-Jui Luo, Yu-Ching Chen, and Bang-Bin Chen.
• Division of Nephrology, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
• J Formos Med Assoc. 2025 Jan 27.

AbstractContrast media are essential agents that enhance the diagnostic capabilities of imaging studies, such as computed tomography and magnetic resonance imaging. However, concerns regarding the risk of adverse events have led to cautious use in patients with chronic kidney disease. A multidisciplinary review by nephrologists, cardiologists, and radiologists at National Taiwan University Hospital examined evidence linking iodinated contrast media and gadolinium-based contrast agents with acute kidney injury and nephrogenic systemic fibrosis. The consensus is that the risk of iodinated contrast-induced acute kidney injury is minimal in patients with an estimated glomerular filtration rate greater than 30 mL/min/1.73 m2. Preventive strategies, including hydration with 0.9% saline and limiting contrast volume, may further reduce acute kidney injury risk in susceptible individuals. For nephrogenic systemic fibrosis, the risk is negligible with group II gadolinium-based contrast agents, even in patients with advanced chronic kidney disease or those on dialysis. The panel concludes that the use of iodinated contrast media or group II gadolinium-based contrast agents should not be postponed in chronic kidney disease patients when clinically significant imaging studies are required.Copyright © 2025 Formosan Medical Association. Published by Elsevier B.V. All rights reserved.

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