Document Detail


Mortality associated with nephropathy after radiographic contrast exposure.
MedLine Citation:
PMID:  18828968     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To define outcomes from contrast-induced nephropathy (CIN) after both intra-arterial and intravenous administration of contrast medium.
PATIENTS AND METHODS: We performed a retrospective case-matched cohort study at Mayo Clinic's site in Rochester, MN, from April 1, 2004, to March 31, 2006. All contrast procedures were evaluated for inclusion. Contrast-induced nephropathy was defined as creatinine elevation of 25% or more after contrast exposure or of more than 0.5 mg/dL within 7 days of contrast exposure. Cases of CIN were matched 1:3 with controls by age, sex, pre-procedure creatinine elevation, diabetes mellitus, and type of imaging procedure.
RESULTS: A total of 809 patients who developed CIN were matched to 2427 patients who did not develop CIN after contrast exposure. In multivariate analyses, CIN was significantly associated with 30-day mortality (odds ratio, 3.37; 95% confidence interval [CI], 2.58-4.41; P<.001) and overall mortality (hazard ratio, 1.57; 95% CI, 1.32-1.86; P<.001) after adjustment for heart failure, hypertension, medications, total hydration, iodine load, prior contrast exposure, and all matched variables during the study period. Intravenous contrast administration was a risk factor for 30-day mortality (odds ratio, 2.91; 95% CI, 1.17-7.23; P=.02) and overall mortality (hazard ratio, 3.02; 95% CI, 1.89-4.82; P<.001) compared with intra-arterial administration of contrast after adjustment for heart failure, hypertension, medications, total hydration, iodine load, prior contrast exposure, and all matched variables during the study period.
CONCLUSION: Contrast-induced nephropathy after administration of contrast medium is associated with increased mortality. This risk is higher in patients in whom contrast medium is administered intravenously than in those in whom it is administered intra-arterially.
Authors:
Aaron M From; Brian J Bartholmai; Amy W Williams; Stephen S Cha; Furman S McDonald
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Mayo Clinic proceedings     Volume:  83     ISSN:  1942-5546     ISO Abbreviation:  Mayo Clin. Proc.     Publication Date:  2008 Oct 
Date Detail:
Created Date:  2008-10-02     Completed Date:  2008-10-21     Revised Date:  2013-12-13    
Medline Journal Info:
Nlm Unique ID:  0405543     Medline TA:  Mayo Clin Proc     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1095-100     Citation Subset:  AIM; IM    
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MeSH Terms
Descriptor/Qualifier:
Acute Kidney Injury / chemically induced,  mortality*
Angiography / adverse effects*,  methods
Contrast Media / adverse effects*
Female
Follow-Up Studies
Humans
Male
Middle Aged
Minnesota / epidemiology
Retrospective Studies
Risk Factors
Severity of Illness Index
Survival Rate / trends
Vascular Diseases / radiography
Chemical
Reg. No./Substance:
0/Contrast Media
Comments/Corrections
Comment In:
Mayo Clin Proc. 2008 Dec;83(12):1412-3; author reply 1413   [PMID:  19046563 ]
Mayo Clin Proc. 2008 Dec;83(12):1412; author reply 1413   [PMID:  19046564 ]

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