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J Nephropathol. 2020;9(1): e05.
doi: 10.15171/jnp.2020.05

Scopus ID: 85078237002
  Abstract View: 234
  PDF Download: 107

Review

Intravenous contrast agents in diabetic patients taking metformin; an updated review on current concepts

Masoumeh Asgharpour 1 ORCID logo, Rouzbeh Danialy 2 ORCID logo, Seyedhadi Mirhashemi 3 * ORCID logo, Semko Ebrahimi 5 ORCID logo

1 Department of Nephrology, Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran
2 Department of Internal Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
3 Department of General Surgery, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
4 Department of Anesthesiology, Health North gGmbH Klinikverbund Bremen, Hospital left of the Weser (klinkum Links der Weser) (Senator-Weßling-Straße 1; 28277), Bremen, Germany
5 Department of Anesthesiology, Health North gGmbH Klinikverbund Bremen, Hospital left of the Weser (klinkum Links der Weser) (Senator-Weßling-Straße 1; 28277), Bremen, Germany
*Corresponding author: Seyed Hadi Mirhashemi; Email: m.mirhashemi67@gmail.com

Abstract

Iodinated contrast agents are routinely used to diagnose a variety of diseases especially malignant tumors. They are crucial for accurate depiction of tumors, monitoring the response to treatment, and assessing possible recurrence of malignant lesions. Unfortunately, there are potential adverse effects associated with their administration. Metformin as an antidiabetic drug is prescribed widely. The drug is usually administered to control type II diabetes mellitus. One of the most important side effects of metformin is the possibility of lactate accumulation and occurrence of metforminassociated lactic acidosis (MALA), which develops under various circumstances including decreased renal function or concurrent use of toxic agents. Since, intravascular injection of iodinated contrast agents for radiologic purposes may result in kidney injury, it is suggested that metformin should be held in diabetic patients with renal failure before administration of contrast media and not to be taken by the patient again till 48 hours after the procedure and assessment of kidney function which should be normal.
Keywords: Metformin, Renal injury, Contrast medium, Diabetes mellitus

Implication for health policy/practice/research/medical education:

Diabetic individuals with renal failure using metformin are at high risk of metformin-associated lactic acidosis if they are scheduled for iodinated contrast study.

Please cite this paper as: Asgharpour M, Danialy R, Mirhashemi SH, Mirzazadeh A, Ebrahimi S. Intravenous contrast agents in diabetic patients taking metformin; an updated review on current concepts. J Nephropathol. 2020;9(1):e05. DOI: 10.15171/jnp.2020.05.

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Submitted: 03 Jul 2019
Accepted: 10 Sep 2019
ePublished: 18 Oct 2019
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