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Computerized tomography contrast induced nephropathy (CIN) among adult inpatients
Luciano Passamani Diogo1, Laura Fuchs Bahlis2, Gustavo Franco Carvalhal3
1Porto Alegre University Hospital.
Insights
Computerized tomography contrast induced nephropathy (CIN) affects 8.5% of inpatients. Diabetes, heart failure, and renal failure are key risk factors for developing CIN after CT scans.
Area of Science:
- Nephrology
- Radiology
- Internal Medicine
Background:
- Contrast-induced nephropathy (CIN) is a reduction in glomerular filtration rate following iodinated contrast agent use.
- Existing CIN research primarily focuses on cardiovascular procedures, with less data on computerized tomography (CT).
- Pre-existing chronic renal insufficiency and diabetes mellitus are known CIN risk factors in cardiovascular studies.
Purpose of the Study:
- To determine the incidence of CT-associated CIN in a tertiary hospital inpatient population.
- To identify potentially avoidable risk factors for CT-associated CIN.
Main Methods:
- Prospective cohort study of inpatients undergoing contrast-enhanced CT.
- CIN defined by serum creatinine or glomerular filtration rate changes within 48-72 hours.
- Clinical interviews assessed risk factors and preventive measures.
Main Results:
- 35 out of 410 patients (8.5%) developed CIN.
- Significant positive correlations found between CIN and diabetes mellitus (OR=2.15), heart failure (OR=2.23), and renal failure (OR=3.36).
Conclusions:
- CIN incidence varies by patient population.
- Diabetes mellitus, heart failure, and renal failure are independent risk factors for CT-associated CIN.
- Further research is necessary for better understanding and treatment of CT-CIN.
Introduction:
Contrast induced nephropathy (CIN) is one of the complications of the use of intravascular contrast agents, being defined as a reduction of the glomerular filtration rate caused by the iodinated contrast. Most CIN data derive from the cardiovascular literature, which identified as the most consistent risk factors pre-existing chronic renal insufficiency and diabetes mellitus. However, these studies limit their conclusions to a more specific patient population. Computerized tomography as a cause of CIN has been studied less often.
Objective:
To report on the incidence of computerized tomography contrast induced nephropathy (CIN) in an inpatient population of a tertiary general hospital, identifying potentially avoidable risk factors.
Methods:
We performed a prospective cohort study with inpatients admitted at a tertiary hospital requiring contrast-induced CT. The primary outcome was the development of CIN, measure by the alteration of serum creatinine or glomerular filtration rate in 48 or 72 hours. Through clinical interview, we verified possible risk factors and preventive measures instituted by the medical team and their association with development of CIN.
Results:
Of a total of 410 patients, 35 (8.5%) developed CIN. There was a positive correlation between CIN and the presence of diabetes mellitus (OR = 2.15; 95%CI 1.35-4.06; p = 0.02), heart failure (OR = 2.23; 95%CI 1.18-8.8; p = 0.022), and renal failure (OR = 3.36; 95%CI 1.57- 7.17; p = 0.002) CONCLUSION: Incidence of CIN varies according to the population. Diabetes mellitus, heart failure and renal failure were independent risk factors for the development of CT-associated CIN. Further studies are needed to better understand and treat CT-associated CIN.
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