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The quality of the guidelines was assessed with the Scientific, Transparent, and Applicable Rankings (STAR) tool.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Ten guidelines were included, with a median STAR score of 46.0 (range 28.5\u201361.5). The guidelines performed well in \u201cRecommendations\u201d domain (31\/40, 78%), while poor in \u201cRegistry\u201d (0\/20, 0%) and \u201cProtocol\u201d domains (0\/20, 0%). Nine guidelines recommended estimated glomerular filtration rate (eGFR) &lt; 30 mL\/min\/1.73 m\n                      <jats:sup>2<\/jats:sup>\n                      as the cutoff for referring patients to discuss the risk-benefit balance of ICM administration. Three guidelines further suggested that patients with an eGFR &lt; 45 mL\/min\/1.73 m\n                      <jats:sup>2<\/jats:sup>\n                      and high-risk factors also need referring. Variable recommendations were seen in the acceptable time interval between renal function test and ICM administration, and that between scan and repeated scan. Nine guidelines recommended to use iso-osmolar or low-osmolar ICM, while no consensus has been reached for the dosing of ICM. Nine guidelines supported hydration after ICM use, but their protocols varied. Drugs or blood purification therapy were not recommended as preventative means.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Guidelines on intravenous ICM use in patients with kidney disease have heterogeneous quality. The scientific societies may consider joint statements on controversial recommendations for variable timing and protocols.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Critical relevance statement<\/jats:title>\n                    <jats:p>The heterogeneous quality of guidelines, and their controversial recommendations, leave gaps in workflow timing, dosing, and post-administration hydration protocols of contrast-enhanced CT scans for patients with kidney diseases, calling for more evidence to establish a safer and more practicable workflow.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Key points<\/jats:title>\n                    <jats:p>\u2022 Guidelines concerning iodinated contrast media use in kidney disease patients vary.<\/jats:p>\n                    <jats:p>\u2022 Controversy remains in workflow timing, contrast dosing, and post-administration hydration protocols.<\/jats:p>\n                    <jats:p>\u2022 Investigations are encouraged to establish a safer iodinated contrast media use workflow.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Graphical Abstract<\/jats:title>\n                  <\/jats:sec>","DOI":"10.1186\/s13244-024-01644-5","type":"journal-article","created":{"date-parts":[[2024,3,18]],"date-time":"2024-03-18T16:01:32Z","timestamp":1710777692000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Just give the contrast? 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