Abstract
Contrast induced nephropathy (CIN) is one of the complications of the use of intravascular contrast agents, being defined as a reduction of the glomerular filtration rate caused by the iodinated contrast. Most CIN data derive from the cardiovascular literature, which identified as the most consistent risk factors pre-existing chronic renal insufficiency and diabetes mellitus. However, these studies limit their conclusions to a more specific patient population. Computerized tomography as a cause of CIN has been studied less often. To report on the incidence of computerized tomography contrast induced nephropathy (CIN) in an inpatient population of a tertiary general hospital, identifying potentially avoidable risk factors. We performed a prospective cohort study with inpatients admitted at a tertiary hospital requiring contrast-induced CT. The primary outcome was the development of CIN, measure by the alteration of serum creatinine or glomerular filtration rate in 48 or 72 hours. Through clinical interview, we verified possible risk factors and preventive measures instituted by the medical team and their association with development of CIN. Of a total of 410 patients, 35 (8.5%) developed CIN. There was a positive correlation between CIN and the presence of diabetes mellitus (OR = 2.15; 95%CI 1.35-4.06; p = 0.02), heart failure (OR = 2.23; 95%CI 1.18-8.8; p = 0.022), and renal failure (OR = 3.36; 95%CI 1.57- 7.17; p = 0.002) CONCLUSION: Incidence of CIN varies according to the population. Diabetes mellitus, heart failure and renal failure were independent risk factors for the development of CT-associated CIN. Further studies are needed to better understand and treat CT-associated CIN.
Highlights
Contrast induced nephropathy (CIN) is one of the complications of the use of intravascular contrast agents, being defined as a reduction of the glomerular filtration rate caused by the iodinated contrast
The objective of our study is to report on the incidence of computerized tomography CIN in an inpatient population of a tertiary general hospital, identifying potentially avoidable risk factors
The variables accessed were: age, gender, diabetes mellitus, hypertension, heart failure, stroke, body mass index (BMI), serum creatinine, glomerular filtration rate (GFR), drug use, metformin, acetyl salicylic acid (ASA), angiotensin conversion enzyme (ACE) inhibitors, beta blockers, non-steroidal anti-inflammatory drugs (NSAIDs), and antibiotics, and the adoption of specific CIN preventive measures instituted by the medical team
Summary
Contrast induced nephropathy (CIN) is one of the complications of the use of intravascular contrast agents, being defined as a reduction of the glomerular filtration rate caused by the iodinated contrast. Contrast induced nephropathy (CIN) is one of the most serious consequences of the use of intravascular contrast agents, being defined as a reduction of the glomerular filtration rate caused by the iodinated contrast.[1,2,3] When not prevented, CIN may result in significant morbidity and mortality.[4,5,6,7,8,9,10,11,12,13,14,15,16] low osmolarity and iso-osmolarity contrast media have been used for more than half a century, its physiopathologic effects on the kidneys remain largely unknown.[17] Most CIN data derive from the cardiovascular literature, which identified as the most consistent risk factors pre-existing chronic renal insufficiency and diabetes mellitus.[18] these studies limit their conclusions to a more specific patient population. These few studies pointed out to diverse incidences and risk factors of CIN, possibly due to differences both in the definition of CIN and in patient characteristics.[19,20,21,22] The objective of our study is to report on the incidence of computerized tomography CIN in an inpatient population of a tertiary general hospital, identifying potentially avoidable risk factors
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