Patient selection and preparation strategies for the use of contrast material in patients with chronic kidney disease

Table 1 Prevalence of chronic kidney disease in the USA[1]

		1988-1994	1999-2004
Stage 1	(persistent albuminuria + normal GFR)	1.7%	1.8%
Stage 2	(persistent albuminuria + GFR 60-89)	2.7%	3.2%
Stage 3	(GFR 30-59)	5.4%	7.7%
Stage 4	(GFR 15-29)	0.2%	0.4%
Stage 5	(kidney failure) 0.2%
Total		10.0%	13.1%

The National Kidney Foundation, USA 2003; The National Health and Nutrition Examination Surveys; and The National Center of Health Statistics. GFR: Glomerular filtration rate.

Table 2 Prevalence of peripheral arterial disease

Increased in diabetes (relative risk increase for PAD > 4.0; 20%-30% have PAD)

Increases significantly with age (40-49 yr 1% → >80 yr 22% equal to doubling each decade)

Increases in CKD

Increases in smoking (2.5), hypertension (1.5), dyslipidemia (1.1), high body mass index, black race

In the U.S. population > 40 yr 4.5% (corresponds to 12 mill) have PAD (AB index < 0.9%) (NHANES), > 60 yr over 10%

PAD: Peripheral arterial disease; CKD: Chronic kidney disease.

Table 3 Gadolinium magnetic resonance contrast

Risk	GFR < 30	GFR 30-60	GFR > 60
High - linear (Omniscan, Magnevist, Optimark, Multihance)	Do not use	Urgent indic.	Can be used
Low - stable, macrocyclic (Dotarem, Gadovist, Prohance)	Urgent indic.	Can be used	Can be used

GFR: Glomerular filtration rate.