Inequity of access to contrast-enhanced cardiovascular magnetic resonance in patients with chronic kidney disease: A survey from the British Society of Cardiovascular Magnetic Resonance
ABSTRACT: Objectives: To examine the provision of cardiovascular magnetic resonance (CMR) using gadolinium-based contrast agents (GBCA) in patients with chronic kidney disease (CKD). Methods: An electronic survey was sent to the service leads of all CMR units in the UK in October 2022 requesting in...
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Elsevier
2025-01-01
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| Series: | Journal of Cardiovascular Magnetic Resonance |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S1097664725000080 |
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| author | William E. Moody Ayisha Mehtab Khan-Kheil Tamara Naneishvili Lucy E. Hudsmith Gabriella Captur Thomas A. Treibel Daniel Sado Timothy Fairbairn Gerry P. McCann Saul G. Myerson Colin Berry Mark Westwood Niall G. Keenan |
| author_facet | William E. Moody Ayisha Mehtab Khan-Kheil Tamara Naneishvili Lucy E. Hudsmith Gabriella Captur Thomas A. Treibel Daniel Sado Timothy Fairbairn Gerry P. McCann Saul G. Myerson Colin Berry Mark Westwood Niall G. Keenan |
| author_sort | William E. Moody |
| collection | DOAJ |
| description | ABSTRACT: Objectives: To examine the provision of cardiovascular magnetic resonance (CMR) using gadolinium-based contrast agents (GBCA) in patients with chronic kidney disease (CKD). Methods: An electronic survey was sent to the service leads of all CMR units in the UK in October 2022 requesting information on current departmental protocols and practices. Results: A response rate of 55% was achieved from the 82 UK CMR units surveyed. There were no known cases of nephrogenic systemic fibrosis (NSF) reported within the past 10 years. Just under half the centers (22 out of 45, 49%) routinely require an estimated glomerular filtration rate (eGFR) in patients before performing contrast-enhanced CMR. Conversely, 18% (8/45) of units do not check eGFR, 20% (9/45) only require an eGFR in patients aged >65 years, while 33% (15/45) assess eGFR in patients known to have CKD. All centers use group II GBCAs: the majority (36/45, 80%) favoring gadobutrol (Gadovist), while gadoterate meglumine (Dotarem) is used in most of the remaining units (8/45, 18%). One in five centers (9/45, 20%) do not currently offer contrast-enhanced CMR to patients with an eGFR <30 mL/min/1.73 m2. Of the CMR units that do offer contrast to this group of patients, 28% (10/36) do not obtain consent for the risk of NSF. Conclusion: One in five centers across the UK does not offer contrast-enhanced CMR to patients with stage 4 and 5 CKD. This finding serves as a call for updated guidance with the intention of standardizing care. |
| format | Article |
| id | doaj-art-102bdbec8fed45d890e6fecbdf29c8e8 |
| institution | OA Journals |
| issn | 1097-6647 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of Cardiovascular Magnetic Resonance |
| spelling | doaj-art-102bdbec8fed45d890e6fecbdf29c8e82025-08-20T02:08:46ZengElsevierJournal of Cardiovascular Magnetic Resonance1097-66472025-01-0127110184610.1016/j.jocmr.2025.101846Inequity of access to contrast-enhanced cardiovascular magnetic resonance in patients with chronic kidney disease: A survey from the British Society of Cardiovascular Magnetic ResonanceWilliam E. Moody0Ayisha Mehtab Khan-Kheil1Tamara Naneishvili2Lucy E. Hudsmith3Gabriella Captur4Thomas A. Treibel5Daniel Sado6Timothy Fairbairn7Gerry P. McCann8Saul G. Myerson9Colin Berry10Mark Westwood11Niall G. Keenan12Institute of Cardiovascular Sciences, College of Medical and Dental Sciences, University of Birmingham, Edgbaston, UK; Department of Cardiology, Queen Elizabeth Hospital Birmingham, University Hospitals Birmingham NHS Foundation Trust, Edgbaston, UK; Corresponding author.The Wolverhampton Heart and Lung Centre, New Cross Hospital, Wolverhampton, UKDepartment of Cardiology, Queen Elizabeth Hospital Birmingham, University Hospitals Birmingham NHS Foundation Trust, Edgbaston, UKDepartment of Cardiology, Queen Elizabeth Hospital Birmingham, University Hospitals Birmingham NHS Foundation Trust, Edgbaston, UKRoyal Free London NHS Foundation Trust, London, UKInstitute of Cardiovascular Science, University College London, London, UK; Barts Heart Centre, St Bartholomew's Hospital, London, UKKing’s College Hospital, London, UKLiverpool Heart and Chest Hospital, Liverpool, UKDepartment of Cardiovascular Sciences, University of Leicester and the NIHR Leicester Biomedical Research Centre, Glenfield Hospital, Leicester, UKDivision of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, UKSchool of Cardiovascular and Metabolic Health, BHF Glasgow Cardiovascular Research Centre, Glasgow, UKBarts Heart Centre, St Bartholomew's Hospital, London, UKWest Herts Teaching Hospitals NHS Trust, Watford, UK; Institute of Clinical Sciences, Imperial College, London, UKABSTRACT: Objectives: To examine the provision of cardiovascular magnetic resonance (CMR) using gadolinium-based contrast agents (GBCA) in patients with chronic kidney disease (CKD). Methods: An electronic survey was sent to the service leads of all CMR units in the UK in October 2022 requesting information on current departmental protocols and practices. Results: A response rate of 55% was achieved from the 82 UK CMR units surveyed. There were no known cases of nephrogenic systemic fibrosis (NSF) reported within the past 10 years. Just under half the centers (22 out of 45, 49%) routinely require an estimated glomerular filtration rate (eGFR) in patients before performing contrast-enhanced CMR. Conversely, 18% (8/45) of units do not check eGFR, 20% (9/45) only require an eGFR in patients aged >65 years, while 33% (15/45) assess eGFR in patients known to have CKD. All centers use group II GBCAs: the majority (36/45, 80%) favoring gadobutrol (Gadovist), while gadoterate meglumine (Dotarem) is used in most of the remaining units (8/45, 18%). One in five centers (9/45, 20%) do not currently offer contrast-enhanced CMR to patients with an eGFR <30 mL/min/1.73 m2. Of the CMR units that do offer contrast to this group of patients, 28% (10/36) do not obtain consent for the risk of NSF. Conclusion: One in five centers across the UK does not offer contrast-enhanced CMR to patients with stage 4 and 5 CKD. This finding serves as a call for updated guidance with the intention of standardizing care.http://www.sciencedirect.com/science/article/pii/S1097664725000080Gadolinium-based contrast agentChronic kidney diseaseCardiovascular magnetic resonanceNephrogenic systemic fibrosis |
| spellingShingle | William E. Moody Ayisha Mehtab Khan-Kheil Tamara Naneishvili Lucy E. Hudsmith Gabriella Captur Thomas A. Treibel Daniel Sado Timothy Fairbairn Gerry P. McCann Saul G. Myerson Colin Berry Mark Westwood Niall G. Keenan Inequity of access to contrast-enhanced cardiovascular magnetic resonance in patients with chronic kidney disease: A survey from the British Society of Cardiovascular Magnetic Resonance Journal of Cardiovascular Magnetic Resonance Gadolinium-based contrast agent Chronic kidney disease Cardiovascular magnetic resonance Nephrogenic systemic fibrosis |
| title | Inequity of access to contrast-enhanced cardiovascular magnetic resonance in patients with chronic kidney disease: A survey from the British Society of Cardiovascular Magnetic Resonance |
| title_full | Inequity of access to contrast-enhanced cardiovascular magnetic resonance in patients with chronic kidney disease: A survey from the British Society of Cardiovascular Magnetic Resonance |
| title_fullStr | Inequity of access to contrast-enhanced cardiovascular magnetic resonance in patients with chronic kidney disease: A survey from the British Society of Cardiovascular Magnetic Resonance |
| title_full_unstemmed | Inequity of access to contrast-enhanced cardiovascular magnetic resonance in patients with chronic kidney disease: A survey from the British Society of Cardiovascular Magnetic Resonance |
| title_short | Inequity of access to contrast-enhanced cardiovascular magnetic resonance in patients with chronic kidney disease: A survey from the British Society of Cardiovascular Magnetic Resonance |
| title_sort | inequity of access to contrast enhanced cardiovascular magnetic resonance in patients with chronic kidney disease a survey from the british society of cardiovascular magnetic resonance |
| topic | Gadolinium-based contrast agent Chronic kidney disease Cardiovascular magnetic resonance Nephrogenic systemic fibrosis |
| url | http://www.sciencedirect.com/science/article/pii/S1097664725000080 |
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