Asma Abubaker Bashir1, Victor Kong2,3, David Skinner4, John Bruce3, Grant Laing3, Petra Brysiewicz5, Damian Clarke2,3. 1. Department of Radiology, Grey's Hospital, Pietermaritzburg, South Africa. docabashir@gmail.com. 2. Department of Surgery, University of the Witwatersrand, Johannesburg, South Africa. 3. Pietermaritzburg Metropolitan Trauma Service, Department of Surgery, University of KwaZulu-Natal, Durban, South Africa. 4. Department of Anesthesia and Critical Care, University of KwaZulu-Natal, Durban, South Africa. 5. School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa.
Abstract
PURPOSE: Acute trauma patients are at risk for the development of acute kidney injury (AKI). One potential nephrotoxic agent, which a trauma patient may be exposed to, is iodinated contrast media (ICM). We aim to review the incidence and outcome of contrast-induced nephropathy (CIN) in trauma patients in a busy trauma service, and to identify potentially modifiable risk factors. METHODS: During the period from December 2012 to April 2017, all patients who underwent a contrast-enhanced CT scan for trauma were included. Data were examined and outcome data were reviewed. RESULTS: A total of 1566 patients required a CT scan following blunt trauma at our institution. Of this total 755 patients underwent a contrast-enhanced CT scan. There were 173 females (22.9%) and 582 males (77.1%). All these patients received intravenous contrast. A total of 143 (18.9%) were admitted to ICU, and 58 (7.7%) of patients died. Detailed electrolyte studies pre- and post-procedure were available for 312 patients. Of these 312 patients, 46 developed CIN (14.7%).There was no difference in the incidence of pre-CT AKI or deranged electrolytes between the patients who developed CIN and those who did not. The development of CIN was associated with an increased risk of death as well as increased need for renal replacement therapy as well as increased need for ICU. CONCLUSION: Contrast-induced nephropathy is a real risk in trauma patients undergoing contrast-enhanced CT scan for blunt trauma in our environment. Further work is needed to define and delineate risk factors.
PURPOSE: Acute traumapatients are at risk for the development of acute kidney injury (AKI). One potential nephrotoxic agent, which a traumapatient may be exposed to, is iodinated contrast media (ICM). We aim to review the incidence and outcome of contrast-induced nephropathy (CIN) in traumapatients in a busy trauma service, and to identify potentially modifiable risk factors. METHODS: During the period from December 2012 to April 2017, all patients who underwent a contrast-enhanced CT scan for trauma were included. Data were examined and outcome data were reviewed. RESULTS: A total of 1566 patients required a CT scan following blunt trauma at our institution. Of this total 755 patients underwent a contrast-enhanced CT scan. There were 173 females (22.9%) and 582 males (77.1%). All these patients received intravenous contrast. A total of 143 (18.9%) were admitted to ICU, and 58 (7.7%) of patients died. Detailed electrolyte studies pre- and post-procedure were available for 312 patients. Of these 312 patients, 46 developed CIN (14.7%).There was no difference in the incidence of pre-CT AKI or deranged electrolytes between the patients who developed CIN and those who did not. The development of CIN was associated with an increased risk of death as well as increased need for renal replacement therapy as well as increased need for ICU. CONCLUSION: Contrast-induced nephropathy is a real risk in traumapatients undergoing contrast-enhanced CT scan for blunt trauma in our environment. Further work is needed to define and delineate risk factors.
Authors: Judith Kooiman; Sharif M Pasha; Wendy Zondag; Yvo W J Sijpkens; Aart J van der Molen; Menno V Huisman; Olaf M Dekkers Journal: Eur J Radiol Date: 2011-12-15 Impact factor: 3.528
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Authors: Erica C Bjornstad; William Muronya; Zachary H Smith; Keisha Gibson; Amy K Mottl; Anthony Charles; Stephen W Marshall; Yvonne M Golightly; Charles K Munthali; Emily W Gower Journal: BMC Nephrol Date: 2020-03-14 Impact factor: 2.388