RESUMEN
PURPOSE: The purpose of this study was to assess the effect of anemia on the incidence of contrast-induced nephropathy (CIN) in patients with renal impairment undergoing MDCT. MATERIALS AND METHODS: Institutional review board approval was waived for this retrospective review of 843 patients with stable renal insufficiency (eGFR between 15 and 60 mL/min) who had undergone contrast-enhanced MDCT. Baseline hematocrit and hemoglobin values were measured. Serum creatinine (SCr) was assessed at the baseline and at 48-72 h after contrast administration. RESULTS: The overall incidence of CIN in the patient population with renal insufficiency was 6.9%. CIN developed in 7.8% (54 of 695) of anemic patients, and in 2.8% (4 of 148) of non-anemic patients (P=.027). After adjustment for confounders, low hemoglobin and low hematocrit values remained independent predictors of CIN (odds ratio 4.6, 95% CI 1.0-20.5, P=.046). CONCLUSIONS: Anemia is associated with a higher incidence of CIN in patients with renal insufficiency. Anemia is a potentially modifiable risk factor for CIN, and has an unfavorable impact on prognosis in patients with renal insufficiency undergoing contrast-enhanced MDCT.
Asunto(s)
Lesión Renal Aguda/epidemiología , Anemia/epidemiología , Efectos Colaterales y Reacciones Adversas Relacionados con Medicamentos/epidemiología , Yohexol , Insuficiencia Renal/diagnóstico por imagen , Insuficiencia Renal/epidemiología , Tomografía Computarizada por Rayos X/estadística & datos numéricos , Lesión Renal Aguda/diagnóstico por imagen , Anciano , Anemia/diagnóstico , Causalidad , Comorbilidad , Medios de Contraste , Femenino , Humanos , Incidencia , Japón/epidemiología , Enfermedades Renales , Masculino , Estudios Retrospectivos , Factores de RiesgoRESUMEN
OBJECTIVES: To evaluate the safety of contrast-enhanced MDCT in patients with renal impairment. METHODS: We conducted a retrospective review of 938 patients with stable renal insufficiency (eGFR between 15 and 60 ml/min) who underwent contrast-enhanced MDCT. SCr levels were measured at baseline and 48-72 h after contrast medium administration. The incidence of contrast-induced nephropathy (CIN) in the total study population was assessed. As a control group, 1,164 separate patients with renal insufficiency who did not receive contrast medium for CT were also reviewed. RESULTS: The overall incidence of CIN in the patient population with renal insufficiency was 6.1 %; the incidence was 4.4 %, 10.5 % and 10.0 % for patients whose eGFR was 45-60, 30-45 and ≤30 ml/min, respectively (P < 0.01). In the control group, 5.8 % of patients showed an increase in the SCr level from the baseline. The increase in the SCr level showed no significant difference between the patients who received CM and those who did not (P = 0.82) CONCLUSIONS: The risk of CIN from contrast-enhanced MDCT in patients with renal insufficiency appeared to be low, and there was no significant difference in the incidence of CIN in comparison with patients who did not receive CM. KEY POINTS : ⢠The contrast medium used for multidetector CT can induce nephropathy. ⢠Contrast-induced nephropathy (CIN) developed in 6.1 % of patients with renal insufficiency. ⢠However, nephropathy developed in 5.8 % of similar patients not receiving contrast medium. ⢠Thus, the risk of CIN associated with MDCT appears to be low. ⢠Special care should still be taken in patients with renal insufficiency.