Yasuhiro Fukushima1,2, Hitomi Miyazawa3, Junpei Nakamura3, Ayako Taketomi-Takahashi4, Takayuki Suto3, Yoshito Tsushima4. 1. Department of Radiology, Gunma University Hospital, 3-39-15 Showa, Maebashi, Gunma, 371-8511, Japan. yasuhiro.fukushima@gmail.com. 2. Division of Clinical Radiology Service, Kyoto University Hospital, 54 Kawaharacho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan. yasuhiro.fukushima@gmail.com. 3. Department of Radiology, Gunma University Hospital, 3-39-15 Showa, Maebashi, Gunma, 371-8511, Japan. 4. Department of Diagnostic Radiology and Nuclear Medicine, Gunma University Graduate School of Medicine, 3-39-22 Showa, Maebashi, Gunma, 371-8511, Japan.
Abstract
PURPOSE: To investigate the incidence and risk factors of contrast induced nephropathy (CIN) after contrast enhanced (CE) computed tomography (CT) in patients with renal dysfunction. MATERIALS AND METHODS: Two hundred sixteen inpatients with estimated glomerular filtration rates (eGFR) <60 ml/min/1.73 m2 underwent CE CT using iodine doses of 420 or 480 mg I/kg. Data of all enrolled patients was collected for baseline serum creatinine level (SCr), post-CE CT SCr within 3 days after CE CT, and conditions considered risk factors for CIN [renal dysfunction, contrast media dose, advanced age, diabetes mellitus, no intravenous hydration, cardiac dysfunction (left ventricular ejection fraction <60%) and intensive-care unit (ICU) admission]. CIN was defined as an increase in SCr level of more than 0.5 mg/dl or more than 25% from baseline within 3 days post-CE CT without any other identifiable cause of acute kidney injury. RESULTS: The incidence of CIN was 11/216 (5.1%) and was associated with cardiac dysfunction [odds ratio (OR) 6.540; 95% confidence interval (CI) 1.090-39.300; p = 0.040] and ICU admission (OR 11.500; 95% CI 2.050-64.100; p = 0.005). CONCLUSION: Our results suggested that cardiac dysfunction and ICU admission may be risk factors for CIN in patients with preexisting renal dysfunction.
PURPOSE: To investigate the incidence and risk factors of contrast induced nephropathy (CIN) after contrast enhanced (CE) computed tomography (CT) in patients with renal dysfunction. MATERIALS AND METHODS: Two hundred sixteen inpatients with estimated glomerular filtration rates (eGFR) <60 ml/min/1.73 m2 underwent CE CT using iodine doses of 420 or 480 mg I/kg. Data of all enrolled patients was collected for baseline serum creatinine level (SCr), post-CE CT SCr within 3 days after CE CT, and conditions considered risk factors for CIN [renal dysfunction, contrast media dose, advanced age, diabetes mellitus, no intravenous hydration, cardiac dysfunction (left ventricular ejection fraction <60%) and intensive-care unit (ICU) admission]. CIN was defined as an increase in SCr level of more than 0.5 mg/dl or more than 25% from baseline within 3 days post-CE CT without any other identifiable cause of acute kidney injury. RESULTS: The incidence of CIN was 11/216 (5.1%) and was associated with cardiac dysfunction [odds ratio (OR) 6.540; 95% confidence interval (CI) 1.090-39.300; p = 0.040] and ICU admission (OR 11.500; 95% CI 2.050-64.100; p = 0.005). CONCLUSION: Our results suggested that cardiac dysfunction and ICU admission may be risk factors for CIN in patients with preexisting renal dysfunction.
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