Purpose The Contrast Media Safety Committee (CMSC) of the European Society of Urogenital Radiology (ESUR) has updated its 2011 guidelines on the prevention of post-contrast acute kidney injury (PC-AKI). The results of the literature review and the recommendations based on it, which were used to prepare the new guidelines, are presented in two papers. Areas covered in part 1 Topics reviewed include the terminology used, the best way to measure eGFR, the definition of PC-AKI, and the risk factors for PC-AKI, including whether the risk with intravenous and intra-arterial contrast medium differs. Key Points • PC-AKI is the preferred term for renal function deterioration after contrast medium. • PC-AKI has many possible causes. • The risk of AKI caused by intravascular contrast medium has been overstated. • Important patient risk factors for PC-AKI are CKD and dehydration.

Objectives The Contrast Media Safety Committee (CMSC) of the European Society of Urogenital Radiology (ESUR) has updated its 2011 guidelines on the prevention of post-contrast acute kidney injury (PC-AKI). The results of the literature review and the recommendations based on it, which were used to prepare the new guidelines, are presented in two papers. Areas covered in part 2 Topics reviewed include stratification of PC-AKI risk, the need to withdraw nephrotoxic medication, PC-AKI prophylaxis with hydration or drugs, the use of metformin in diabetic patients receiving contrast medium and the need to alter dialysis schedules in patients receiving contrast medium. Key points • In CKD, hydration reduces the PC-AKI risk • Intravenous normal saline and intravenous sodium bicarbonate provide equally effective prophylaxis • No drugs have been consistently shown to reduce the risk of PC-AKI • Stop metformin from the time of contrast medium administration if eGFR < 30 ml/min/1.73 m ² • Dialysis schedules need not change when intravascular contrast medium is given

Our findings indicate that obesity is associated with smaller subcortical gray matter volumes and higher coherence but lower magnitude of white matter microstructure. These results indicate the need for future studies on the biologic basis of alterations in brain structure in obesity. Background Obesity has been associated with increased risk of accelerated cognitive decline and dementia, which suggests underlying neurobiological changes. Purpose To investigate the associations between obesity and brain structure (overall and regional brain volumes, and white matter microstructure) assessed at MRI in a sample of the general population. Materials and Methods Between March 2014 and January 2018, 12 087 participants (52.8% women [6381 of 12 087]; mean age, 62 years; age range, 45–76 years) in the prospective observational UK Biobank study underwent 3.0-T multiparametric (ie, three-dimensional T1-weighted diffusion tensor imaging [DTI]) brain imaging. Percentage of total body fat (TBF) was assessed by body impedance. Volumetric measures included brain volume, gray matter volume, white matter volume, volumes of subcortical gray matter structures, and regional cortical volumes. Global and tract-specific microstructure was assessed by fractional anisotropy (FA) and mean diffusivity (MD) by us...

Gene-set analysis provides insight into which functional and biological properties of genes are aetiologically relevant for a particular phenotype. But genes have multiple properties, and these properties are often correlated across genes. This can cause confounding in a gene-set analysis, because one property may be statistically associated even if biologically irrelevant to the phenotype, by being correlated with gene properties that are relevant. To address this issue we present a novel conditional and interaction gene-set analysis approach, which attains considerable functional refinement of its conclusions compared to traditional gene-set analysis. We applied our approach to blood pressure phenotypes in the UK Biobank data (N = 360,243), the results of which we report here. We confirm and further refine several associations with multiple processes involved in heart and blood vessel formation but also identify novel interactions, among others with cardiovascular tissues involved in regulatory pathways of blood pressure homoeostasis.

Summary: Background and objectives: Because little is known about long-term treatment-related nephrotoxicity, the aim was to determine risk factors for renal impairment long after childhood cancer treatment. Design, setting, participants, & measurements: Data from 763 adult childhood cancer survivors (414 men) were obtained during regular visits at the late-effects clinic between 2003 and 2009. Median follow-up time was 18.3 years (range=5.0–58.2). Glomerular function was assessed by estimated GFR (using the Modification of Diet in Renal Disease formula), urinary albumin creatinine ratio, and tubular function by urinary β ₂-microglobulin creatinine ratio. The association with treatment factors was analyzed with covariance analysis for estimated GFR and logistic regression for urinary albumin and urinary β ₂-microglobulin creatinine ratios. Results: Survivors treated with nephrectomy and abdominal irradiation had significantly lower estimated GFR than survivors not treated with nephrectomy/abdominal irradiation (estimated mean=90 ml/min per 1.73 m² versus 106, P<0.001). Estimated GFR was significantly lower in survivors after treatment with high-dose ifosfamide (88 versus 98, P=0.02) and high-dose cisplatin (83 versus 101, P=0.004) compared with survivors not treated with these regimen. Nephrectomy combined with abdominal radiotherapy (odds ratio=3.14, 95% confidence interval=1.02; 9.69) and high-dose cisplatin (odds ratio=5.19, 95% confidence interval=1.21; 22.21) was associated with albuminuria. High-dose ifosfamide (odds ratio=6.19, 95% confidence interval=2.45; 15.67) was associated with increased urinary β ₂-microglobulin creatinine ratio. Hypertension was present in 23.4% of survivors and 31.4% of renal tumor survivors. Conclusions: Treatment with unilateral nephrectomy, abdominal radiotherapy, cisplatin, and ifosfamide was associated with lower estimated GFR. Persisting tubular damage was related to ifosfamide treatment.

Incidentally discovered findings on brain magnetic resonance imaging (MRI) in healthy persons pose medical and ethical considerations regarding management.¹ The prevalence of incidental findings on brain MRI has been described in adult populations,² but less is known about incidental findings in children. We report the prevalence of incidental findings on brain MRI in a large, single-center neuroimaging study involving a general pediatric population. From April 2013 through November 2015, a total of 3966 children (mean age, 10.1 years; range, 8.6 to 11.9) in the population-based Generation R Study³ — designed to prospectively identify early environmental and genetic influences on normal and abnormal growth, development, and health during fetal life, childhood, and young adulthood — underwent MRI scanning of the brain on a single 3-Tesla scanner. Scans were systematically reviewed by trained researchers and neuroradiologists for the presence of incidental findings ( Table 1 ).