TY - JOUR
T1 - Intravenous ct contrast media and acute kidney injury
T2 - A multicenter emergency department-based study
AU - Su, Tse Hsuan
AU - Hsieh, Chih Huang
AU - Chan, Yi Ling
AU - Wong, Yon Cheong
AU - Kuo, Chang Fu
AU - Li, Chih Huang
AU - Lee, Cheng Chia
AU - Chen, Hsien Yi
N1 - Publisher Copyright:
© 2021 Radiological Society of North America Inc.. All rights reserved.
PY - 2021/12
Y1 - 2021/12
N2 - Background: Although the historical risk of acute kidney injury (AKI) after intravenous administration of contrast media might be overstated, the risk in patients with impaired kidney function remains a concern. Purpose: To investigate whether intravenous contrast media administration during CT is associated with a higher risk of AKI and further hemodialysis compared with the risk in patients undergoing unenhanced CT. Materials and Methods: This retrospective study evaluated patients who underwent contrast-enhanced or unenhanced CT in five Taiwanese emergency departments between 2009 and 2016. The outcomes were AKI within 48-72 hours after CT, AKI within 48 hours to 1 week after CT, or further hemodialysis within 1 month after CT. The associations between contrast media exposure and outcome were estimated by using an overlap propensity score weighted generalized regression model. Subgroup analyses were performed according to the estimated glomerular filtration rate (eGFR). Results: The study included 68 687 patients (median age, 68 years; interquartile range, 53-74 years; 39 995 men) with (n = 31 103) or without (n = 37 584) exposure to contrast media. After propensity score weighting, contrast media exposure was associated with higher risk of AKI within 48-72 hours after CT (odds ratio [OR], 1.16; 95% CI: 1.04, 1.29; P = .007) but no significant risk at 48 hours to 1 week after CT (OR, 1.00; 95% CI: 0.93, 1.08; P = .90). Among patients with eGFR less than 30 mL/min/1.73 m2, exposure to contrast media was associated with a higher AKI risk (48-72 hours after CT: OR, 1.36; 95% CI: 1.09, 1.70; P = .007) (48 hours-1 week after CT: OR, 1.49; 95% CI: 1.27, 1.74; P , .001) and a higher risk of hemodialysis (OR, 1.36; 95% CI: 1.09, 1.70; P = .008). For patients with eGFR greater than 45 mL/min/1.73.m2, contrast media exposure was not associated with higher AKI risk (P . .05). Conclusion: Contrast-enhanced CT was associated with higher risk of acute kidney injury and further hemodialysis among Taiwanese patients with an estimated glomerular filtration rate (eGFR) of less than 30 mL/min/1.73 m2but not those with an eGFR of more than 45 mL/min/1.73
AB - Background: Although the historical risk of acute kidney injury (AKI) after intravenous administration of contrast media might be overstated, the risk in patients with impaired kidney function remains a concern. Purpose: To investigate whether intravenous contrast media administration during CT is associated with a higher risk of AKI and further hemodialysis compared with the risk in patients undergoing unenhanced CT. Materials and Methods: This retrospective study evaluated patients who underwent contrast-enhanced or unenhanced CT in five Taiwanese emergency departments between 2009 and 2016. The outcomes were AKI within 48-72 hours after CT, AKI within 48 hours to 1 week after CT, or further hemodialysis within 1 month after CT. The associations between contrast media exposure and outcome were estimated by using an overlap propensity score weighted generalized regression model. Subgroup analyses were performed according to the estimated glomerular filtration rate (eGFR). Results: The study included 68 687 patients (median age, 68 years; interquartile range, 53-74 years; 39 995 men) with (n = 31 103) or without (n = 37 584) exposure to contrast media. After propensity score weighting, contrast media exposure was associated with higher risk of AKI within 48-72 hours after CT (odds ratio [OR], 1.16; 95% CI: 1.04, 1.29; P = .007) but no significant risk at 48 hours to 1 week after CT (OR, 1.00; 95% CI: 0.93, 1.08; P = .90). Among patients with eGFR less than 30 mL/min/1.73 m2, exposure to contrast media was associated with a higher AKI risk (48-72 hours after CT: OR, 1.36; 95% CI: 1.09, 1.70; P = .007) (48 hours-1 week after CT: OR, 1.49; 95% CI: 1.27, 1.74; P , .001) and a higher risk of hemodialysis (OR, 1.36; 95% CI: 1.09, 1.70; P = .008). For patients with eGFR greater than 45 mL/min/1.73.m2, contrast media exposure was not associated with higher AKI risk (P . .05). Conclusion: Contrast-enhanced CT was associated with higher risk of acute kidney injury and further hemodialysis among Taiwanese patients with an estimated glomerular filtration rate (eGFR) of less than 30 mL/min/1.73 m2but not those with an eGFR of more than 45 mL/min/1.73
UR - http://www.scopus.com/inward/record.url?scp=85121263385&partnerID=8YFLogxK
U2 - 10.1148/radiol.2021204446
DO - 10.1148/radiol.2021204446
M3 - 文章
C2 - 34636631
AN - SCOPUS:85121263385
SN - 0033-8419
VL - 301
SP - 571
EP - 581
JO - Radiology
JF - Radiology
IS - 3
ER -