BACKGROUND: The risk of acute kidney injury produced by intravenous radiocontrast in patients with chronic kidney disease (CKD) has been well known, but little is known about the long-term effects on renal function. METHODS: We retrospectively reviewed the medical records of 176 CKD patients with estimated glomerular filtration rates (eGFR) <60 ml/min/1.73 m(2) who underwent computed tomography (CT) with intravenous radiocontrast at Pusan National University Hospital. Patients were divided into 3 groups (CKD stage 3, n = 104; CKD stage 4, n = 52; peritoneal dialysis, n = 20). Follow-up eGFR values were assessed on a monthly basis for up to 8 months. RESULTS: In baseline characteristics, there were no significant differences between the 3 groups (i.e., CKD stage 3, stage 4, and PD) in the variables of age, sex, presence of diabetes and follow-up period. There were no significant differences between eGFR before and after CT in all patients and each of the 3 investigated groups. In each group, data analysis according to the presence of diabetes mellitus (DM) did not show significant differences of eGFR before and after CT. CONCLUSION: Overall, these results illustrate that intravenous contrast media used in the standard CT scan have no significant long-term effects on renal function in CKD patients, irrespective of DM. Therefore, from a long-term perspective, contrast-enhanced CT might be a better option than gadolinium-based magnetic resonance imaging, which is known to be associated with fatal nephrogenic systemic fibrosis in CKD patients.
BACKGROUND: The risk of acute kidney injury produced by intravenous radiocontrast in patients with chronic kidney disease (CKD) has been well known, but little is known about the long-term effects on renal function. METHODS: We retrospectively reviewed the medical records of 176 CKDpatients with estimated glomerular filtration rates (eGFR) <60 ml/min/1.73 m(2) who underwent computed tomography (CT) with intravenous radiocontrast at Pusan National University Hospital. Patients were divided into 3 groups (CKD stage 3, n = 104; CKD stage 4, n = 52; peritoneal dialysis, n = 20). Follow-up eGFR values were assessed on a monthly basis for up to 8 months. RESULTS: In baseline characteristics, there were no significant differences between the 3 groups (i.e., CKD stage 3, stage 4, and PD) in the variables of age, sex, presence of diabetes and follow-up period. There were no significant differences between eGFR before and after CT in all patients and each of the 3 investigated groups. In each group, data analysis according to the presence of diabetes mellitus (DM) did not show significant differences of eGFR before and after CT. CONCLUSION: Overall, these results illustrate that intravenous contrast media used in the standard CT scan have no significant long-term effects on renal function in CKDpatients, irrespective of DM. Therefore, from a long-term perspective, contrast-enhanced CT might be a better option than gadolinium-based magnetic resonance imaging, which is known to be associated with fatal nephrogenic systemic fibrosis in CKDpatients.
Authors: Marc C Heinrich; Martin K Kuhlmann; Aleksandar Grgic; Martina Heckmann; Bernhard Kramann; Michael Uder Journal: Radiology Date: 2005-04-21 Impact factor: 11.105
Authors: M R Rudnick; S Goldfarb; L Wexler; P A Ludbrook; M J Murphy; E F Halpern; J A Hill; M Winniford; M B Cohen; D B VanFossen Journal: Kidney Int Date: 1995-01 Impact factor: 10.612
Authors: P S Parfrey; S M Griffiths; B J Barrett; M D Paul; M Genge; J Withers; N Farid; P J McManamon Journal: N Engl J Med Date: 1989-01-19 Impact factor: 91.245