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We advise clinicians to do the following to improve patient safety:

1) Limit the volume of administered gadolinium-based contrast agents when used
kidney360.asnjournals.org/content/early/…

#gadolinium
☢️#radiology
#nephrology
🏥#patientsafety
#risk #management
#medical #ethics
#FOAMed
2) increase patient education, incorporate informed consent and shared decision making when GBCA administration occurs;

kidney360.asnjournals.org/content/early/…

#gadolinium
☢️#radiology
#nephrology
🏥#patientsafety
#risk #management
#medical #ethics
#FOAMed
3) maintain careful institutional records of administered agents along with the volume and frequency,

kidney360.asnjournals.org/content/early/…

#gadolinium
☢️#radiology
#nephrology
🏥#patientsafety
#risk #management
#medical #ethics
#FOAMed
and 4) employ institutional outcome review and follow up for gadolinium deposition in those receiving multiple doses.

kidney360.asnjournals.org/content/early/…

#gadolinium
☢️#radiology
#nephrology
🏥#patientsafety
#risk #management
#medical #ethics
#FOAMed
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B. Wagner, M.D.
@Wagner_Nephro
Now: “Dialyzing the Undocumented: Driving Policy with Data”
by Dr. Lilia Cervantes, M.D.
Denver Health Medical Center and the University of Colorado Anschutz Medical Group
@Cervantes_Lily1 University of New Mexico Health Science Center Department of Medicine Grand Rounds
“Patients sometimes consumed foods [knowingly] high in potassium,” in order to gain admission — @Cervantes_Lily1 University of New Mexico Health Science Center Department of Medicine Grand Rounds
“So, you are asking me to keep a patient sicker so you can make more money? I am sorry, that is not why I became a physician,” @Cervantes_Lily1 University of New Mexico Health Science Center Department of Medicine Grand Rounds
Read 16 tweets
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B. Wagner, M.D.
@Wagner_Nephro
“Around 2012 or 2013, researchers identified evidence that gadolinium retention was connected to illness in patients with normal kidney function.” scholar.google.com/scholar_case?c…
“In September 2017, after the FDA voted to add concerns about gadolinium retention on warning labels, [gadolinium-based contrast agent] manufacturers, including Defendants, issued a new joint warning to patients with normal kidney function.” scholar.google.com/scholar_case?c…
“The warning [RE: #gadolinium retention] also directed physicians to advise patients of these concerns.”

Consent: valued in the United States since the Nuremberg trials of 1947 🇺🇸 scholar.google.com/scholar_case?c…

☢️#radiology
🥼#nephrology
🏥#publichealth ⚠️#patientsafety
💉#MRIdye
Read 4 tweets
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B. Wagner, M.D.
@Wagner_Nephro
“[T]he American College of Radiology have categorized the various ligands into different safety classes ... despite being grounded in purely observational data,” physiology.org/doi/full/10.11…
#gadolinium ☠️ #patientsafety #radiology #Nephrology
The “American College of Radiology] Committee on Drugs and Contrast Media considers the risk of [‘nephrogenic’ systemic fibrosis] among patients exposed to standard or lower than standard doses of group II [gadolinium-based contrast agents] is ... possibly nonexistent...”
The American College of Radiology, based on more opinion than evidence, guided Group II agents—such as MultiHance—as having “sufficiently low or possibly nonexistent” risk for gadolinium-induced systemic fibrosis. acr.org/Clinical-Resou…
#gadolinium ☠️ #radiology ☢️ #Nephrology
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