Intravenous contrast use and acute kidney injury: a retrospective study of 1,238 inpatients undergoing computed tomography
Radiol Bras . Mar-Apr 2021;54(2):77-82. doi: 10.1590/0100-3984.2020.0018.
Thyago A Coser, Juliana S V Leitão, Betina M Beltrame, Luciano S Selistre, Leandro Tasso
Objective: To determine the incidence of nephropathy induced by intravenous contrast in hospitalized patients undergoing computed tomography (CT).
Materials and methods: This was a retrospective cohort study involving 1,238 patients who underwent CT with or without intravenous administration of a contrast agent (iopromide). The primary outcome measure was acute kidney injury (AKI), as defined by the traditional criteria-an absolute or relative increase in serum creatinine (SCr) ≥ 0.5 mg/dL or ≥ 25% over baseline, respectively, at 2-3 days after contrast administration-and the newer, Kidney Disease: Improving Global Outcomes (KDIGO) criteria-an absolute or relative increase in SCr ≥ 0.3 mg/dL or ≥ 50% over baseline, respectively, at 2-7 days after contrast administration.
Results: The overall incidence of AKI was 11.52% when the KDIGO criteria were applied. Univariate logistic regression demonstrated a significant association between an absolute post-CT increase in SCr ≥ 0.5 mg/dL and AKI, although that association did not retain significance in the multivariate analysis. Multivariate logistic regression initially found an association between an absolute post-CT increase in SCr ≥ 0.3 mg/dL and advanced age, although that association was not maintained after correction. We found no association between AKI and the risk factors evaluated.
Conclusion: We identified no criteria for contrast-induced nephropathy after CT; nor did we find AKI to be associated with the classical risk factors.
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