Contrast-Induced Acute Kidney Injury Among Patients With Chronic Kidney Disease Undergoing Imaging Studies: A...

Area of Science:

• Nephrology
• Radiology
• Pharmacology

Background:

• Contrast-induced nephropathy (CIN) is a significant concern for patients with chronic kidney disease (CKD) undergoing contrast-enhanced imaging.
• Evaluating the renal risk associated with intravenous (IV) contrast medium (CM) administration in CKD patients is crucial.

Purpose of the Study:

• To conduct a meta-analysis evaluating the risk of CIN in patients with CKD following IV CM administration.
• To assess the impact of CM on renal function across different stages of CKD.

Main Methods:

• A systematic literature search of PubMed and MEDLINE up to October 3, 2018, was performed.
• Studies involving patients with CKD and a control group, using IV CM, were selected for meta-analysis.
• Subgroup analysis was conducted based on estimated glomerular filtration rate (eGFR) to assess CIN risk by CKD stage.

Main Results:

• Six studies with 55,963 participants were included. IV CM infusion did not significantly increase the risk of CIN in CKD patients (OR, 1.07; 95% CI, 0.98-1.17).
• Analyses across different CKD stages (2, <3, 3, <4, 4, 5) showed no significant difference in CIN risk between CM recipients and controls.
• The odds ratios for CIN across CKD stages ranged from 0.26 to 1.11, with confidence intervals often including 1, indicating no statistically significant increase in risk.

Conclusions:

• Retrospective cohort studies, including this meta-analysis, have not demonstrated a clear association between IV radiographic CM and renal damage in patients with CKD.
• While this meta-analysis suggests a lack of increased CIN risk, it is limited by the retrospective nature of the included studies.
• Further research may be needed to explore other potential risk factors for CIN that might not have been evenly distributed in the analyzed studies.