medicina61巻5号

2024年04月発行

特集 腎機能を考慮した内科疾患の診療 治療・薬物療法が腎機能の影響を受けやすい内科的疾患 〈検査〉

造影剤腎症はあるのか？—救急医の立場から

著者： 中田貴史¹ 工藤秀将¹ 久志本成樹¹

所属機関： ¹東北大学病院高度救命救急センター

ページ範囲：P.753 - P.757

Point
◎造影剤による腎機能障害のリスクは過大評価されている可能性がある．
◎造影剤使用によるメリットが期待される緊急の状況においては，腎機能障害を理由に造影剤投与を控える必要はない．
◎適切なリスク評価に基づき，造影剤使用後の腎保護に努める．

参考文献

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11）van der Molen AJ, et al：Post-contrast acute kidney injury. Part 2；Risk stratification, role of hydration and other prophylactic measures, patients taking metformin and chronic dialysis patients；Recommendations for updated ESUR Contrast Medium Safety Committee guidelines. Eur Radiol 28：2856-2869, 2018 PMID 29417249

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13）Ehmann MR, et al：Renal outcomes following intravenous contrast administration in patients with acute kidney injury；A multi-site retrospective propensity-adjusted analysis. Intensive Care Med 49：205-215, 2023 PMID 36715705

14）Shaish H, et al：Diagnostic accuracy of unenhanced computed tomography for evaluation of acute abdominal pain in the emergency Department. JAMA Surg 158：e231112, 2023 PMID 37133836

15）久志本成樹：急性腎障害患者への造影剤投与—必要なときはためらわない．　https://www.m3.com/clinical/news/1133843（2023年11月閲覧）