| Mortality associated with nephropathy after radiographic contrast exposure. | |
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MedLine Citation:
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PMID: 18828968 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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Aaron M From; Brian J Bartholmai; Amy W Williams; Stephen S Cha; Furman S McDonald |
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Publication Detail:
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Type: Comparative Study; Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Mayo Clinic proceedings. Mayo Clinic Volume: 83 ISSN: 1942-5546 ISO Abbreviation: Mayo Clin. Proc. Publication Date: 2008 Oct |
Date Detail:
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Created Date: 2008-10-02 Completed Date: 2008-10-21 Revised Date: 2008-12-30 |
Medline Journal Info:
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Nlm Unique ID: 0405543 Medline TA: Mayo Clin Proc Country: United States |
Other Details:
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Languages: eng Pagination: 1095-100 Citation Subset: AIM; IM |
Affiliation:
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Division of Cardiovascular Diseases, Mayo Clinic, 200 First St SW, Rochester, MN 55905, USA. from.aaron@mayo.edu |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Angiography
/
adverse effects*,
methods Contrast Media / adverse effects* Female Follow-Up Studies Humans Kidney Failure, Acute / chemically induced, mortality* Male Middle Aged Minnesota / epidemiology Retrospective Studies Risk Factors Severity of Illness Index Survival Rate / trends Vascular Diseases / radiography |
| Chemical | |
Reg. No./Substance:
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0/Contrast Media |
| Comments/Corrections | |
Comment In:
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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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