Italian 
English DOCUMENTI SIBIOC - SIBioC Documents
Volume:
Biochimica Clinica 2014; 38(2) 139-142
Pubblicato on-line:
DOI:
Documento di consenso SIBioC e Società Italiana di Radiologia Medica (SIRM) sulla richiesta di esami di laboratorio per la valutazione del danno renale da mezzi di contrasto
AUTORI
Presidente SIBioC – Medicina di Laboratorio
Michele Mussap1, Maria Stella Graziani2, Anna Caldini3, Alberto Dolci4, Giampaolo Merlini5 a nome del Gruppo di Studio SIBioC Proteine
1UOC Medicina di Laboratorio, IRCCS San Martino-IST, Istituto Nazionale per la Ricerca sul Cancro, Genova
2Azienda Ospedaliera Universitaria Integrata di Verona
3Laboratorio Generale, Dipartimento Aziendale Integrato di Diagnostica Laboratorio, Azienda Ospedaliero-Universitaria Careggi, Firenze
4UOC Patologia Clinica, Azienda Ospedaliera “Luigi Sacco”, Milano
5Centro per lo Studio e la Cura delle Amiloidosi Sistemiche, Fondazione IRCCS Policlinico San Matteo e Dipartimento di Medicina Molecolare, Università di Pavia
ABSTRACT
SIBioC-SIRM consensus document on the request of laboratory tests for evaluation of contrast media nephrotoxicity
The contrast media, widely used in imaging diagnostics, show a favorable safety profile. As the presence of pre-existing disease is considered a risk factor for adverse events, patients should be carefully evaluated prior to the procedure. The aim of this consensus document is to recommend appropriate biochemical tests to be performed for an early recognition of individuals at higher risk of contrast media nephrotoxicity. This condition is defined by an increase of serum creatinine concentrations of at least 0.50 mg/dL and/or 25% within 3-4 days from contrast media exposure. The most important risk factor is renal insufficiency [estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m2 or serum creatinine >1.50 mg/dL]. Other risk factors are age >75 years, dehydration, diabetes, heart failure and anemia. Monoclonal gammopathies, multiple myeloma, Waldenström macroglobulinemia and amyloidosis are not considered risk factors per se. On the basis of available guidelines, it is recommended: a) prior to the examination, to measure serum creatinine baseline with a method traceable to the international reference measurement system and report its concentration together with the eGFR using the Chronic Kidney Disease – Epidemiology Collaboration (CKD-EPI) equation; b) for monitoring, to measure serum creatinine more than once calculating the delta from the baseline value: if serum creatinine increases >5%, repeat the test within 48-72 h. Performing of laboratory tests to exclude the presence of monoclonal gammopathies (i.e., serum protein electrophoresis, Bence Jones protein determination, serum free light chain measurements) is not required.