Abstract
Background. Aging is associated with renal structural changes and functional decline. The attributable risk for renal dysfunction from radiocontrast agents in critically ill older patients has not been well established. Methods. In this prospective study, we assessed the incidence of contrast-induced nephropathy (CIN) in critically ill patients with stable renal function who underwent computed tomography with intravenous contrast media. Patients were categorized into two age groups: <65 (YG) or ≥65 years old (OG). CIN was defined as 25% or greater increase from baseline of serum creatinine or as an absolute increase by 0.5 mg/dL until the 5th day after the infusion of contrast agent. We also evaluated the alterations in oxidative stress by assessing serum 8-isoprostane. Results. CIN occurred in 5 of 13 OG patients (38.46%) whereas no YG patient presented CIN (P = 0.015). Serum creatinine kinetics in older patients demonstrated a rise over five days following contrast infusion time while a decline was observed in the YG (P = 0.005). Conclusions. Older critically ill patients are more prone to develop renal dysfunction after the intravenous infusion of contrast agent in relation to their younger counterparts.
Highlights
Contrast-induced nephropathy (CIN) is a well-established complication of the use of the intravenous iodine contrast media representing the third most common cause of acute kidney injury in hospitalized patients [1]
We aimed to investigate whether the risk for critically ill patients >65 years old to develop contrast-induced nephropathy (CIN) after exposure to intravenous contrast media is higher compared to critical care patients aged less than 65 years old
Five patients in the OG fulfilled the criteria for CIN 38.46%, while no one did in YG (P = 0.015)
Summary
Contrast-induced nephropathy (CIN) is a well-established complication of the use of the intravenous iodine contrast media representing the third most common cause of acute kidney injury in hospitalized patients [1]. Several risk factors have been related to CIN like decreased baseline renal function, heart failure, diabetes, dehydration, hypotension, older age, and the type and the amount of contrast agent applied [11,12,13]. Ill is a group of patients who shared many predisposing factors for CIN which have been studied during the last few years with various results in respect to the incidence of CIN [14]. In this prospective study, we assessed the incidence of contrast-induced nephropathy (CIN) in critically ill patients with stable renal function who underwent computed tomography with intravenous contrast media. Older critically ill patients are more prone to develop renal dysfunction after the intravenous infusion of contrast agent in relation to their younger counterparts
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