Don’t perform serum protein electrophoresis nor search of urinary Bence-Jones protein as laboratory test before contrast media administration.
The only real drawback for the administration of contrast media is renal insufficiency. It can be diagnosed measuring serum creatinine (increased) and calculating the glomerular filtration rate (eGFR). These are the only laboratory tests to perform. Patients with multiple myeloma or other plasmacellular diseases* (situation in which Bence-Jones proteinuria can be present) may have renal insufficiency, but not all these patients have reduced renal function. For this reason these diseases do not constitute a risk factor for contrast media induced nephropathy. Thus it is not necessary to perform specific tests to exclude plasmacellular diseases (serum protein electrophoresis, Bence-Jones protein analysis), moreover because none of these test is sufficient to exclude these diseases. * disorders characterized by plasmacellular proliferation.
1. Mussap M, et al. A nome del gruppo di studio SIBioC Proteine. Documento di consenso SIBioC e Società Italiana di Radiologia Medica (SIRM) sulla richiesta di esami di laboratorio per la valutazione del danno renale da mezzi di contrasto. Biochim Clin 2014; 38: 140-2.
2. Mussap M, Merlini G. Pathogenesis of renal failure in multiple myeloma: any role of contrast media? Biomed Res Int. 2014; 2014: 167125. doi: 10.1155/2014/167125. Epub 2014 Apr 30.
3. European Society of Urogenital Radiology (ESUR). Guidelines on Contrast Media. www.esur.org/guidelines /it
Attention. Please note that these items are provided only for information and are not intended as a substitute for consultation with a clinician. Patients with any specific questions about the items on this list or their individual situation should consult their clinician.