Buscar en
Radiología (English Edition)
Toda la web
Inicio Radiología (English Edition) The administration of contrast media: Is there a risk of acute kidney injury?
Journal Information
Vol. 61. Issue 4.
Pages 306-314 (July - August 2019)
Share
Share
Download PDF
More article options
ePub
Visits
19
Vol. 61. Issue 4.
Pages 306-314 (July - August 2019)
Original article
The administration of contrast media: Is there a risk of acute kidney injury?
Administración de medios de contraste. ¿Existe riesgo de daño renal agudo?
Visits
...
M.D. Ferrer Puchola,
Corresponding author
, P. Montesinos Garcíaa, M. Forment Navarroa, E. Sanz Rodrigob, E. Blanco Péreza, E. Taberner Lópeza
a Servicio de Radiología, Hospital Universitario de la Ribera, Alzira, Valencia, Spain
b Analista de Sistema, Hospital Universitario de la Ribera, Alzira, Valencia, Spain
Article information
Abstract
Full Text
Bibliography
Download PDF
Statistics
Figures (3)
Show moreShow less
Tables (5)
Table 1. Clinical and demographic characteristics of the patients.
Table 2. Bivariate comparison between patients who underwent computed tomography (CT) and those who did not.
Table 3. Bivariate comparison between patients who underwent computed tomography (CT) with and without contrast.
Table 4. Logistic regression, combining both sets of criteria for kidney injury (AKIN+CIN).
Table 5. Glomerular filtration rate data (CKD-EPI), combining both sets of criteria for kidney injury (AKIN+CIN). Logistic regression analysis.
Show moreShow less
Abstract
Objective

To determine whether the intravenous administration of iodinated contrast material for computed tomography (CT) is associated with an increase in creatinine levels and acute kidney injury.

Material and methods

This retrospective cohort study included all patients who presented at the emergency department between 2010 and 2015 with baseline creatinine measurement (C1) and follow-up creatinine measurement (C2) between 24 and 72h later. The clinical research ethics committee approved the study. The exclusion criteria were age <18 years, creatinine ≤0.4mg/dl or ≥4.0mg/dl, and the administration of contrast media within the previous 6 months. The mean number of patients presenting at the emergency department was 105,435.6 per year. Patients who met the inclusion criteria were classified into three groups: those who underwent contrast-enhanced CT (n=6642), those who underwent noncontrast CT (n=6193), and those who did not undergo CT (n=33,802). We used the Acute Kidney Injury Network's (AKIN) and the Contrast-induced Nephropathy Consensus Working Panel's (CIN) criteria. Statistical analyses included bivariate statistics and logistic regression. Stata 15 was used for all statistical analyses.

Results

We analysed 52,411 patients; after data cleansing: 46,637; mean age: 67.95 years; C1: mean 1.16mg/dl (SD: 0.61); C2: 1.14mg/dl (SD: 0.66). With AKIN and CIN criteria: contrast-enhanced CT was not associated with a greater probability of developing nephropathy (odds ratio [OR: 0.90; 95% CI: 0.83–0.99] and [OR 0.89, 95% CI: 0.81–0.98], respectively). The propensity score matching study using both sets of criteria (AKIN+CIN) yielded OR 0.80 [95% CI: 0.77–0.84]. Glomerular filtration rates less than 30ml/min were not associated with increased kidney damage [OR: 0.66, 95% CI: 0.47–0.91].

Conclusion

The administration of intravenous contrast material in the patients studied is not associated with increased acute kidney injury.

Keywords:
Computed tomography
Multidetector CT
Contrast-induced nephropathy
Nephroprotection
Resumen
Objetivo

Conocer si la administración intravenosa de contraste yodado en la tomografía computarizada (TC) se asocia a un aumento en los niveles de creatinina y de daño renal agudo.

Material y métodos

Estudio de cohortes retrospectivo. Incluye todos los pacientes que acudieron al servicio de urgencias del 2010 al 2015 y que presentaban una creatinina basal (C1) y otra 24-72 horas después (C2). El Comité de Ética y de Investigación aprobó el estudio. Criterios de exclusión: paciente menor de 18 años, creatinina ≤0,4mg/dl, ≥4,0mg/dl y administración de contraste en los últimos 6 meses. Al servicio de urgencias acudieron una media de 105.435,6 pacientes/año. Tres grupos de pacientes: 1) TC con contraste (6.642), 2) TC sin contraste (6.193,3) y 3) Sin TC (33.802). Se usaron los criterios de Acute Kidney Injury Network (AKI) y nefropatía aguda por contraste (NAC). Se realizó estudio estadístico bivariante y de regresión logística con el programa (Stata15).

Resultados

Se analizaron 52.411 pacientes; depurando datos: 46.637. Edad media: 67,95 años. Valor de C1: media 1,16mg/dl (DE: 0,61) y de C2: 1,14mg/dl (DE: 0,66). Con criterios AKI y NAC: la realización de TC con contraste no se asocia a una mayor probabilidad de desarrollar nefropatía (odds ratio [OR]: 0,90, intervalo de confianza [IC]: 0,83-0,99 y OR 0,89, IC: 0,81-0,98, respectivamente). El estudio “propensity score matching”, usando ambos criterios (AKI+NAC), obtuvo una OR de 0,80 y una IC de 0,77-0,84. Pacientes con filtrado glomerular inferior a 30ml/min no asociaron incremento del daño renal (OR: 0,66, IC: 0,47-0,91).

Conclusión

La administración de contraste intravenoso, en el grupo de pacientes estudiados, no está asociada a un aumento del daño renal agudo.

Palabras clave:
Tomografía computarizada
TC multidetector
Nefropatía por contraste
Nefroprotección

Article

These are the options to access the full texts of the publication Radiología (English Edition)
Subscriber
Subscriber

If you already have your login data, please click here .

If you have forgotten your password you can you can recover it by clicking here and selecting the option “I have forgotten my password”
Purchase
Purchase article

Purchasing article the PDF version will be downloaded

Price 19.34 €

Purchase now
Contact
Phone for subscriptions and reporting of errors
From Monday to Friday from 9 a.m. to 6 p.m. (GMT + 1) except for the months of July and August which will be from 9 a.m. to 3 p.m.
Calls from Spain
932 415 960
Calls from outside Spain
+34 932 415 960
E-mail
Article options
Tools
es en pt

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?

Você é um profissional de saúde habilitado a prescrever ou dispensar medicamentos