Long-term effect of radiocontrast-enhanced computed tomography on the renal function of chronic kidney disease patients

Abstract

Background: The risk of acute kidney injury produced by intravenous radiocontrast in patients with chronic kidney disease (CKD) has been well known, but little is known about the long-term effects on renal function.

Methods: We retrospectively reviewed the medical records of 176 CKD patients with estimated glomerular filtration rates (eGFR) <60 ml/min/1.73 m(2) who underwent computed tomography (CT) with intravenous radiocontrast at Pusan National University Hospital. Patients were divided into 3 groups (CKD stage 3, n = 104; CKD stage 4, n = 52; peritoneal dialysis, n = 20). Follow-up eGFR values were assessed on a monthly basis for up to 8 months.

Results: In baseline characteristics, there were no significant differences between the 3 groups (i.e., CKD stage 3, stage 4, and PD) in the variables of age, sex, presence of diabetes and follow-up period. There were no significant differences between eGFR before and after CT in all patients and each of the 3 investigated groups. In each group, data analysis according to the presence of diabetes mellitus (DM) did not show significant differences of eGFR before and after CT.

Conclusion: Overall, these results illustrate that intravenous contrast media used in the standard CT scan have no significant long-term effects on renal function in CKD patients, irrespective of DM. Therefore, from a long-term perspective, contrast-enhanced CT might be a better option than gadolinium-based magnetic resonance imaging, which is known to be associated with fatal nephrogenic systemic fibrosis in CKD patients.