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Published on: January 16, 2019
Risk of contrast induced nephropathy in the critically ill: a prospective, case matched study
Cynthia M Cely1, Roland M H Schein, Andrew A Quartin
1Division of Pulmonary, Critical Care, and Sleep Medicine, University of Miami Miller School of Medicine, 1600 NW 10th Ave, Miami, FL 33136, USA.
Critical Care (London, England)
|April 27, 2012
Summary
Contrast-enhanced scans in intensive care units (ICUs) are common. However, declines in kidney function after these scans are usually due to other factors, not the contrast material itself.
Area of Science:
- Nephrology
- Radiology
- Critical Care Medicine
Background:
- Computerized tomography (CT) with intravenous radiocontrast is common in critically ill patients.
- These patients often have risk factors for contrast-induced nephropathy (CIN) and other renal injuries.
- The specific risk of CIN in this population is not well-quantified.
Purpose of the Study:
- To quantify the attributable risk of renal dysfunction from radiocontrast exposure in critically ill patients.
- To compare the incidence of contrast-induced nephropathy (CIN) versus other causes of renal injury in intensive care unit (ICU) patients.
Main Methods:
- Prospective matched cohort study in a Veterans Affairs Medical Center ICU.
- Patients undergoing CT with or without contrast were matched for pre-scan creatinine clearance, diabetes, mechanical ventilation, and vasopressor use.
- Renal function (creatinine clearance) was monitored for three days post-scan.
Main Results:
- 53 matched pairs of patients were analyzed.
- Declines in creatinine clearance occurred in both contrast and non-contrast groups.
- The incidence of contrast-associated nephropathy lasting three days was low, with an upper bound of 2%.
Conclusions:
- Declines in glomerular filtration post-contrast CT are common in ICU patients but often multifactorial.
- Factors other than contrast material are the primary drivers of renal dysfunction in this setting.
- The risk of CIN lasting three days is minimal (≤2%) in critically ill patients.
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