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. 2019 Jul-Aug;61(4):306-314.
doi: 10.1016/j.rx.2019.01.005. Epub 2019 Mar 23.

The administration of contrast media: is there a risk of acute kidney injury?

[Article in English, Spanish]
M D Ferrer Puchol  1 , P Montesinos García  2 , M Forment Navarro  2 , E Sanz Rodrigo  3 , E Blanco Pérez  2 , E Taberner López  2
Affiliations
Free article

The administration of contrast media: is there a risk of acute kidney injury?

[Article in English, Spanish]
M D Ferrer Puchol et al. Radiologia (Engl Ed). 2019 Jul-Aug.
Free article

Abstract

Objective: To determine whether the intravenous administration of iodinated contrast material for computed tomography (CT) is associated with an increase in creatinine levels and acute kidney injury.

Material and methods: This retrospective cohort study included all patients who presented at the emergency department between 2010 and 2015 with baseline creatinine measurement (C1) and follow-up creatinine measurement (C2) between 24 and 72hours later. The clinical research ethics committee approved the study. The exclusion criteria were age <18 years, creatinine ≤ 0.4mg/dl or ≥4.0mg/dl, and the administration of contrast media within the previous 6 months. The mean number of patients presenting at the emergency department was 105,435.6 per year. Patients who met the inclusion criteria were classified into three groups: those who underwent contrast-enhanced CT (n=6,642), those who underwent noncontrast CT (n=6,193), and those who did not undergo CT (n=33,802). We used the Acute Kidney Injury Network's (AKIN) and the Contrast-induced Nephropathy Consensus Working Panel's (CIN) criteria. Statistical analyses included bivariate statistics and logistic regression. Stata 15 was used for all statistical analyses.

Results: We analyzed 52,411 patients; after data cleansing: 46,637; mean age: 67.95 years; C1: mean 1.16mg/dl (SD: 0.61); C2: 1.14mg/dl (SD: 0.66). With AKIN and CIN criteria: contrast-enhanced CT was not associated with a greater probability of developing nephropathy (odds ratio [OR: 0.90; 95% CI: 0.83-0.99] and [OR 0.89, 95% CI: 0.81-0.98], respectively). The propensity score matching study using both sets of criteria (AKIN+CIN) yielded OR 0.80 [95% CI: 0.77-0.84]. Glomerular filtration rates less than 30ml/min were not associated with increased kidney damage [OR: 0.66, 95% CI: 0.47-0.91].

Conclusion: The administration of intravenous contrast material in the patients studied is not associated with increased acute kidney injury.

Keywords: Computed tomography; Contrast-induced nephropathy; Multidetector CT; Nefropatía por contraste; Nefroprotección; Nephroprotection; TC multidetector; Tomografía computarizada.

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