milena taskovska

MD, urologist,NCO Slovenia at ESRU; assisstant - surgery at Faculty of medicine, University of Ljubljana; PhD student

[Dr. Chacón-Lozsán F .'. @franciscojlk]

🩻Contrast-induced AKI:
one of the biggest myths still shaping clinical decisions

For decades we were taught:

👉 “Contrast damages the kidneys”
👉 “Avoid CT with contrast in CKD”
👉 “Hydrate, protect, delay imaging if needed”

But what if… most of this is wrong?🤔

->The uncomfortable reality

Modern evidence shows:

👉 Low-osmolar contrast rarely causes true nephrotoxicity
👉 Even in CKD, AKI, and ICU patients
👉 The risk is often overestimated—or nonexistent

So where did the fear come from?

📍 1950s high-osmolar contrast (actually toxic)
📍 Poorly controlled observational studies
📍 “Creatinine rise = contrast injury” assumption

👉 Correlation became causation
👉 And the dogma stayed

⚠️What recent data tells us

✔ No difference in AKI rates with vs without contrast
✔ No benefit from bicarbonate, NAC, or aggressive hydration
✔ Even ICU and AKI patients show no worsening outcomes

->Translation to real life

👉 The patient was going to develop AKI anyway...Not because of contrast!!

->The real problem: “Renalism”

👉 Avoiding necessary imaging
👉 Delaying diagnosis
👉 Choosing inferior tests

And that leads to:

❌ Missed PE
❌ Delayed sepsis source control
❌ Worse outcomes

->Clinical mindset shift

Instead of asking:

👉 “Will contrast harm the kidneys?”

We should ask:

👉 “Will NOT doing the scan harm the patient?”

->Who still deserves caution?

✔ eGFR <30
✔ Severe hemodynamic instability
✔ Multiple nephrotoxins

Even then:

👉 Optimize volume
👉 Minimize dose
👉 Don’t delay critical imaging

🤓Bottom line

✔ Contrast nephrotoxicity exists… but is rare
✔ The fear is bigger than the risk
✔ The harm of NOT imaging is often greater

In critical care

👉 We don’t treat creatinine
👉 We treat patients

And sometimes…

👉 The most dangerous thing is NOT the contrast

👉 It’s hesitation.

📃Reference
Florens N, Demiselle J.
Kidney360 7: 445–449, 2026. doi: https://t.co/CWzi7WC9Wx

[milena taskovska @militasko]

2 wonderful days in #barcelona …. Exquisite #ralrp, tips on management of #ProstateCancer and very inspiring look into the future of #bladdercancer … thanks to the experts @AntonioAlcarazA @tonivilaseca for this excellent meeting 🙏

[milena taskovska @militasko]

@MaartenAlbersen @Uroweb @EAUYAUrology @UrowebESU @eau_yuo @EauPatient Congratulations on the excellent organization! Looking forward to #eau26

[milena taskovska @militasko]

#EAU25 #madrid day3
Great start of the day with some evergreen questions in endourology…

[milena taskovska @militasko]

Wonderful day 1 od #EAU25 #Madrid

[milena taskovska @militasko]

I want to express the gratitude for the help that they offered and the medical care and treatment they are offering. Thanks to our colleagues from Bulgaria 🇧🇬 , Greece 🇬🇷 , Serbia 🇷🇸, Turkiye 🇹🇷 , Croatia 🇭🇷- благодаря, Σας ευχαριστώ, hvala, Teşekkürler!

[milena taskovska @militasko]

Today is very sad and tragic day for North Macedonia🇲🇰. Neary 60 casualties and over 150 injured in the fire. More than 20 patients were transported in the neighboring counties for further treatment. 1/2

[milena taskovska @militasko]

Excited to share our results at the #eau25 in the most beautiful capital in Europe #madrid non vemos en madrid ;)

[milena taskovska @militasko]

Extend and share your knowledge on #placentaresearch, #stemcellresearch, #celltherapy and #tissueengineering with experts in the field.
Abstract submission is extended until the June 30th.
Join us at #IPLASS-#CTESS meeting 2024 in Izola, Slovenia.

https://t.co/VdfzYn9rTq

[milena taskovska @militasko]

https://t.co/UUmgy2bbk3

[milena taskovska @militasko]

#NewProfilePic

[milena taskovska @militasko]

#eau24 day4
Looking at urology treatments from patient perspective
Importance of LND in patients with MIBC

[milena taskovska @militasko]

#eau24 day4
Very interesting talks on use od radiotherapy in patients with metastatic RCC and systemic therapy

[milena taskovska @militasko]

#eau24 day3
Role of lymphadenectomy in PCa
Excellent lecture on robotic kidney autotransplantation by prof Breda

[milena taskovska @militasko]

#eau24 day 3
SP is coming :)

[milena taskovska @militasko]

#eau24 day 3
Wonderful start of the day with complications in urologic surgery
And as prof Liatsikos said: every surgeon has complications except the one who is not operating

[milena taskovska @militasko]

#eau24 day2
Wonderful start of the day and a lot of surgery… open surgery is not dead! SP is coming in Europe

[milena taskovska @militasko]

#eau24
Very nice talk by @PheVeronique but unfortunately some of our male colleagues “mentally” are not there yet
Very important take home message by prof Montorsi

[milena taskovska @militasko]

Wonderful day 1 at #EAU24

[MCG Urology @mcg_urology]

Varicocele