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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Main Authors: 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
Format: Article
Language:English
Published: Elsevier 2025-01-01
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.
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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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