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Review
. 2021 Jul 5:20:e20200161.
doi: 10.1590/1677-5449.200161. eCollection 2021.

Creatinine level variation in patients subjected to contrast-enhanced tomography: a meta-analysis

André Brusamolin Moro  1 , João Gabriel Nakka Strauch  2 , Anderson Dillmann Groto  3 , Jeferson Freitas Toregeani  1   4
Affiliations
Review

Creatinine level variation in patients subjected to contrast-enhanced tomography: a meta-analysis

André Brusamolin Moro et al. J Vasc Bras. .

Abstract
in English, Portuguese

Variation in the creatinine levels of patients who have undergone contrast-enhanced computed tomography (CT) has been adopted as a practical method for assessment of possible kidney damage caused by the contrast. Criteria employed include an absolute increase in serum creatinine ≥ 0.5 mg/dL or a relative increase ≥ 25% as indicative of possible renal disorders, such as contrast-induced nephropathy (CIN). Our objective was to analyze the incidence of CIN by means of a meta-analysis of nine articles related to incidence of kidney damage caused by contrast, calculating odds ratios (OR) and confidence intervals (95%CI) using RStudio. The overall incidence of CIN in patients who had CT scans was 11.29%, with an OR of 1.38 (95%CI 0.88-2.16). Non-ionic contrasts are safer than other types of contrast, and volumes exceeding 115 mL may be associated with CIN. Preexisting kidney disease had a statistically significant relationship with worse CIN rates.

Resumo: A variação do valor encontrado nos exames de creatinina em pacientes submetidos à tomografia computadorizada (TC) contrastada tem sido utilizada como método prático para a avaliação de possíveis lesões renais causadas pelo uso do contraste. Entre os critérios, considera-se o aumento absoluto de creatinina sérica ≥ 0,5 mg/dL ou relativo em ≥ 25% para possíveis distúrbios renais, como a nefropatia induzida por contraste (NIC). Nosso objetivo foi analisar a incidência de NIC através de uma metanálise envolvendo nove artigos relacionados à incidência de lesão renal por contraste, sendo calculado o odds ratio (OR) e o intervalo de confiança (IC95%) por meio do programa RStudio. A incidência de NIC em pacientes submetidos a TC foi de 11,29%, sendo o OR de 1,38 (IC95% 0,88–2,16). Contrastes não iônicos apresentam maior segurança em seu uso que outros tipos de contraste, e o volume maior que 115 mL pode estar relacionado a NIC. A doença renal prévia apresentou significado estatístico em agravar a NIC.

Keywords: contrast media; kidney diseases; tomography.

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Conflict of interest statement

Conflicts of interest: No conflicts of interest declared concerning the publication of this article.

Figures

Figure 1
Figure 1. Flow diagram.
Figure 2
Figure 2. Forest plot. OBS: Hemmett et al., – the first phase of the study was conducted from December 1 to December 12, 2012; Hemmett et al., – the second phase of the study was conducted from October 1 to October 13, 2013.
Figura 1
Figura 1. Fluxograma.
Figura 2
Figura 2. Forest plot. OBS: Hemmett et al., – a primeira fase desse estudo foi realizada entre os dias 1 e 12 de dezembro de 2012; Hemmett et al., – a segunda fase desse estudo foi realizada entre os dias 1 e 13 de outubro de 2013.
See this image and copyright information in PMC

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