What type of agent is recommended for a patient with an eGFR of 25 who needs GBCM?

In the context of gadolinium-based contrast media (GBCM) administration, patients with a significantly reduced estimated glomerular filtration rate (eGFR), such as 25, are at an increased risk for nephrogenic systemic fibrosis (NSF). To mitigate this risk, the recommended agents are macrocyclic gadolinium contrast agents.

Macrocyclic agents have a more stable chemical structure compared to linear agents, which means they are less likely to release gadolinium into the body. This stability is particularly important in patients with compromised renal function, as their ability to excrete gadolinium is impaired. Therefore, using a macrocyclic agent minimizes the risk of gadolinium-related complications, such as NSF.

In summary, for patients with eGFR values indicating compromised renal function, the selection of macrocyclic GBCM is essential to ensure safety and reduce potential adverse effects associated with contrast media.