Advances in safety assessment of enhanced CT and MRI scanning in tuberculosis patients complicated with chronic kidney disease

doi:10.3969/j.issn.1000-6621.2018.03.019

Abstract

Abstract:

Patients with tuberculosis (or suspected tuberculosis) or lung cancer complicated with chronic kidney disease (CKD) are increasing. Some special adverse reactions may appear during enhanced CT or MRI scanning, which require clinicians’ attention. Contrast-induced nephropathy (CIN) is the most serious adverse reaction by iodine contrast medium that is used during enhanced CT scanning. CIN can be prevented and treated. Properly selecting appropriate contrast medium type and dosage, discontinuing nephrotoxic drugs, and receiving hydration therapy before and after examination can minimize the occurrence of CIN in CKD and other high risk patients. Nephropathy systemic fibrosis (NSF) is the most serious adverse reaction by gadolinium contrast medium that is used during enhanced MRI scanning. NSF can be prevented but is difficult to be treated. Patients with stage 4 or 5 CKD, acute kidney injury or undergoing dialysis should avoid the use of gadolinium contrast medium.

Key words: Renal insufficiency,chronic, Tuberculosis, Contrast media, Drug toxicity, Tomography,X-ray computed, Magnetic resonance imaging, Protective agents, Review

Tao JIN. Advances in safety assessment of enhanced CT and MRI scanning in tuberculosis patients complicated with chronic kidney disease[J]. Chinese Journal of Antituberculosis, 2018, 40(3): 315-319. doi: 10.3969/j.issn.1000-6621.2018.03.019

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