Flowchart

 

* For eGFR ≤ 15 ml/min/1.73m² or congestive heart failure NYHA 3-4

Stop NSAIDs. Consider alternative imaging without ICM. Correct any hypovolemia (NaCl 0.9% or Ringers Lactate). Individualize preventive hydration (by nephrologist/cardiologist). Perform imaging with ICM. Measure follow-up eGFR after 2-7 days and act on outcome.

 

Disclaimer

General

The aim of clinical guidelines is to help clinicians to make informed decisions about their patients. However, adherence to a guideline does not guarantee a successful outcome. Ultimately, healthcare professionals must make their own treatment decisions about care on a case-by-case basis, after consultation with their patients, using their clinical judgement, knowledge and expertise. A guideline is not intended to take the place of physician judgment in diagnosing and treatment of particular patients.

 

Guidelines may not be complete or accurate. The Working Group of this guideline and members of their boards, officers and employees disclaim all liability for the accuracy or completeness of a guideline, and disclaim all warranties, express or implied to their incorrect use.

 

Guidelines users always are urged to seek out newer information that might impact the diagnostic and treatment recommendations contained within a guideline.

 

Individualisation

In specific high risk patient groups (e.g. in patients with high-grade congestive heart failure or end-stage chronic kidney disease) clinicians may have to regress from these general guidelines and decide on individualisation of preventive measures to best fit the needs of their patients.

 

Life-threatening situations or conditions

In acute life-threatening situations or conditions clinicians may have to regress from these general guidelines and decide on individualisation of renal function estimation or preventive measures to best fit the needs of their patients in these situations or conditions.