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Risk of nephropathy after consumption of nonionic contrast media by children undergoing cardiac angiography: a

Ghloamhossein Ajami1, Ali Derakhshan, Hamid Amoozgar

  • 1Divisions of Pediatric Cardiology and Pediatric Nephrology, Department of Pediatrics, Nemazee Hospital, Shiraz University of Medical Sciences, Shiraz, Iran. ajamigh@sums.ac.ir

Pediatric Cardiology
|March 3, 2010
PubMed

Insights

Contrast media-induced nephropathy (CIN) affects 18.75% of pediatric cardiac angiography patients. Higher contrast media dosage, not type or cyanosis, increases CIN risk, necessitating preventative strategies in children.

Area of Science:

  • Pediatric Nephrology
  • Interventional Cardiology
  • Radiology

Background:

  • Contrast media-induced nephropathy (CIN) is increasingly reported in adults undergoing cardiac procedures.
  • Pediatric data on CIN, predisposing factors, and prevention are limited, especially for cardiac angiography.

Purpose of the Study:

  • To determine the incidence of CIN in pediatric patients undergoing cardiac angiography.
  • To compare CIN rates related to nonionic contrast media type (iopromide vs. iohexol), dosage, and cyanosis presence.

Main Methods:

  • Prospective study of 80 pediatric patients (<18 years) undergoing cardiac angiography.
  • Serum creatinine and urine electrolytes measured at baseline and 12, 24, 48 hours post-contrast.
  • CIN defined using RIFLE criteria; incidence analyzed by contrast type, dosage, and cyanosis.

Main Results:

  • Overall CIN incidence was 18.75% (15/80 patients).
  • Higher contrast media dosage significantly increased CIN incidence (p=0.014).
  • Contrast media type and cyanosis presence did not significantly affect CIN rates.

Conclusions:

  • Clinically silent CIN is not rare in pediatric cardiac angiography patients.
  • CIN incidence is dose-dependent but not influenced by contrast type or cyanosis.
  • Preventative measures for CIN in children require greater attention despite its usual reversibility.

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