The aim of the guidelines is to ensure the prevention of kidney injury induced by iodinated contrast media by promoting the appropriate use of contrast media and the standardization of kidney function testing in patients undergoing contrast radiography. The target audience of the present guidelines includes physicians who are using contrast media and physicians who order contrast radiography, as well as other healthcare professionals such as radiation technologists and nurses involved in contrast radiography.

The present guidelines have been prepared to provide recommendations for patients with CKD who are at high risk for developing Cell Cycle inhibitor CIN. The classification of CKD is evaluated on the basis

of the cause, kidney function (glomerular filtration rate [GFR]), and presence and severity of albuminuria, patients with CKD may include those in CKD stages G1 and G2 with a GFR of ≥60 mL/min/1.73 m2. However, PCI-32765 research buy readers should be aware that patients with CKD are defined as those with a GFR of <60 mL/min/1.73 m 2 in the present guidelines. A cautionary note on the use of the present guidelines The present guidelines have been prepared for use according to the National Health Insurance (NHI) regulations in Japan. The present guidelines provide direction on using contrast media in the clinical setting. Physicians have the final responsibility to maximize the benefits for their patients by deciding, on the basis of their patients’ physical and pathological conditions, whether contrast media should be given and whether measures to prevent CIN are necessary. Any use of contrast media that is not consistent with the present guidelines reflects the decisions made by

the attending physicians on the basis of conditions specific to their patients, and their decisions should be prioritized. The present guidelines do not provide any legal basis for prosecuting physicians who do not use contrast media according to the guidelines. Selection of literature, levels of evidence, and grades of recommendations The present guidelines were prepared according to the procedures proposed Erlotinib order by the Medical Information Network Distribution Service (Minds) of the Japan Council for Quality Health Care. The guideline writing committee selected a total of 9 themes regarding CIN. Working groups for the 9 themes, each of which consists of at least 1 representative from 1 of the 3 societies, drafted clinical questions (CQs) for the relevant theme, and selected the CQs to be addressed in the guidelines by using the Delphi method. The working groups addressed the CQs by critically reviewing literature published from 1960 to August 31, 2011 by using major literature databases (e.g.