Multiple myeloma and monoclonal gammopathies should not be considered contraindications for the use of iodine-based contrast media, according to new guidelines from the European Society of Urogenital Radiology (ESUR).
After performing an extensive literature review, the ESUR's Contrast Media Safety Committee concluded that multiple myeloma and monoclonal gammopathies are not risk factors for postcontrast acute kidney injury (PC-AKI) in these patients. However, they did find the risk of risk of PC-AKI may become significant in dehydrated patients with impaired renal function.
"Hypercalcaemia may increase the risk of kidney damage, and should be corrected before contrast medium administration," the committee wrote in the guidelines published online on 30 August in European Radiology. "Assessment for Bence-Jones proteinuria is not necessary."
The ESUR committee analysis encompassed 13 studies with a total of 642 patients with multiple myeloma or monoclonal gammopathies. Of the 824 total iodine-based contrast administrations, only 12 (1.6%) resulted in unconfounded cases of PC-AKI. Most of these patients had received intravenous urography with high osmolarity ionic contrast media after preparatory dehydration and purgation, according to the committee.
