Ghaneh Fananapazir1, Christoph Troppmann2, Michael T Corwin3, Arian M Nikpour3, Sima Naderi3, Ramit Lamba3. 1. Department of Radiology, University of California Davis Medical Center, 4860 Y Street, Suite 3100, Sacramento, CA, 95817, USA. fananapazir@ucdavis.edu. 2. Department of Surgery, University of California Davis Medical Center, 2221 Stockton Boulevard, Suite B, Sacramento, CA, 95817, USA. 3. Department of Radiology, University of California Davis Medical Center, 4860 Y Street, Suite 3100, Sacramento, CA, 95817, USA.
Abstract
PURPOSE: To determine the incidence of acute kidney injury (AKI), need for emergent dialysis, and renal graft loss in patients with kidney transplants, who underwent CT examinations with low-osmolality iodine-based contrast material (IBCM). MATERIALS AND METHODS: Our institutional review board approved this retrospective Health Insurance Portability and Accountability Act compliant study. From January 2005 to April 2015, a total of 224 CT examinations were performed using low-osmolality IBCM in patients with kidney transplants. Six patients who had septic or cardiogenic shock and 30 patients with documented, failed transplants were excluded from our analysis, yielding a total of 188 examinations. Of these, pre- and post-CT serum creatinine (SCr) values were available for 104 examinations, to allow evaluation of AKI. The mean baseline SCr and estimated glomerular filtration rate (eGFR) in this subgroup were 1.37 mg/dL (median 1.18, range 0.5-6.05) and 65.8 mL/min/1.73 m2, respectively (median 65, range 9-114). AKI was defined as a rise in SCr of either (a) ≥0.3 mg/dL or (b) ≥0.5 mg/dL in the 24- to 72-h period following IBCM administration. For all patients undergoing the 188 examinations, need for dialysis and graft loss 30 days after contrast administration were evaluated. RESULTS: In patients with pre- and post-CT SCr values, the incidence of AKI was 7% (7/104) based on a rise of ≥0.3 mg/dL and 3% (3/104) based on a rise of ≥0.5 mg/dL. All three patients with the more strict definition (≥0.5 mg/dL) had a pre-CT eGFR <60 mL/min/1.73 m2. No patient required dialysis or had renal graft loss 30 days after contrast administration. CONCLUSION: The incidence of AKI after administration of low-osmolality IBCM administration in renal transplant recipients is low, with no instances of emergent dialysis or graft loss at 30 days post contrast.
PURPOSE: To determine the incidence of acute kidney injury (AKI), need for emergent dialysis, and renal graft loss in patients with kidney transplants, who underwent CT examinations with low-osmolality iodine-based contrast material (IBCM). MATERIALS AND METHODS: Our institutional review board approved this retrospective Health Insurance Portability and Accountability Act compliant study. From January 2005 to April 2015, a total of 224 CT examinations were performed using low-osmolality IBCM in patients with kidney transplants. Six patients who had septic or cardiogenic shock and 30 patients with documented, failed transplants were excluded from our analysis, yielding a total of 188 examinations. Of these, pre- and post-CT serum creatinine (SCr) values were available for 104 examinations, to allow evaluation of AKI. The mean baseline SCr and estimated glomerular filtration rate (eGFR) in this subgroup were 1.37 mg/dL (median 1.18, range 0.5-6.05) and 65.8 mL/min/1.73 m2, respectively (median 65, range 9-114). AKI was defined as a rise in SCr of either (a) ≥0.3 mg/dL or (b) ≥0.5 mg/dL in the 24- to 72-h period following IBCM administration. For all patients undergoing the 188 examinations, need for dialysis and graft loss 30 days after contrast administration were evaluated. RESULTS: In patients with pre- and post-CT SCr values, the incidence of AKI was 7% (7/104) based on a rise of ≥0.3 mg/dL and 3% (3/104) based on a rise of ≥0.5 mg/dL. All three patients with the more strict definition (≥0.5 mg/dL) had a pre-CT eGFR <60 mL/min/1.73 m2. No patient required dialysis or had renal graft loss 30 days after contrast administration. CONCLUSION: The incidence of AKI after administration of low-osmolality IBCM administration in renal transplant recipients is low, with no instances of emergent dialysis or graft loss at 30 days post contrast.
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