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Radiocontrast-associated renal dysfunction: incidence and risk factors
E M Lautin1, N J Freeman, A H Schoenfeld
1Department of Radiology, Monteifore Medical Center, Bronx, NY 10467.
AJR. American Journal of Roentgenology
|July 1, 1991
Summary
Contrast-induced nephropathy, a reaction to radiologic contrast media, is more common in patients with diabetes and renal insufficiency. Incidence varies by definition, highlighting risk factors like baseline kidney function and diabetes.
Area of Science:
- Nephrology
- Radiology
- Clinical Medicine
Background:
- Contrast-induced nephropathy (CIN) is a significant complication of radiologic contrast media.
- Predisposing factors and precise incidence of CIN remain incompletely understood due to methodological variations in studies.
Purpose of the Study:
- To evaluate the incidence of CIN following femoral arteriography.
- To identify significant predisposing conditions for CIN.
Main Methods:
- A cohort of 394 patients undergoing femoral arteriography was assessed.
- Multiple definitions of CIN based on serum creatinine and blood urea nitrogen changes were employed.
- Statistical analysis was used to determine the significance of various risk factors.
Main Results:
- Using a specific definition (serum creatinine increase >0.3 mg/dl and >20%), CIN incidence was 10% in non-azotemic vs. 30% in azotemic patients.
- Diabetic patients had a significantly higher incidence (16%) compared to non-diabetic patients (2%) among the non-azotemic group.
- Patients with both diabetes and azotemia showed a 38% incidence of CIN.
Conclusions:
- Baseline renal insufficiency and diabetes mellitus are significant risk factors for CIN.
- The incidence of CIN is definition-dependent.
- While CIN can occur in any patient, key risk factors include diabetes, renal insufficiency, and potentially contrast volume and dehydration.