| Risk of contrast induced nephropathy in the critically ill: a prospective, case matched study. | |
| | |
MedLine Citation:
|
PMID: 22534554 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
|
ABSTRACT: INTRODUCTION: Computerized tomography is frequently employed in the critically ill, often using intravenous radiocontrast material. Many of these patients have clinical features that are considered risk factors for contrast induced nephropathy, but are simultaneously at risk for renal injury from other factors related to their acute illnesses. The attributable risk for renal dysfunction from radiocontrast exposure has not been well quantified in this population. METHODS: Prospective matched cohort study of patients scanned with or without radiocontrast enhancement while receiving intensive care in a Veterans Affairs Medical Center. Patients were matched for pre-scan measured creatinine clearance, diabetes, mechanical ventilation, and vasopressor use. Measured clearance was followed for 3 days following scanning. Evolution of nephropathy, as determined by change in measured clearance, was compared within matched pairs. RESULTS: 53 pairs of patients satisfied matching criteria. Unmatched characteristics were similar among the pairs, including serum creatinine variability during the week preceding scanning (67+/-85% among contrast recipients, 63+/-62% among others) and clinical risk factors for renal failure. In 29 pairs, pre-scan measured clearances were less than 60 mL/min/1.73 m2. Following scanning measured clearance declined by at least 33% in 14 contrast and 19 non-contrast patients (95% confidence interval for contrast associated difference in nephropathy rates 27% to 9%), while a 50% reduction in clearance persisted 3 days after scanning in 3 contrast and 9 non-contrast patients (95% confidence interval for difference in rates 25% to 2%). CONCLUSIONS: Among established intensive care unit patients declines in glomerular filtration following contrast enhanced scanning are common, but these changes are far more likely to be attributable to factors other than the contrast exposure itself. The upper bound for the incidence of contrast induced renal injury lasting even 3 days was 2% in the population studied. |
| | |
Authors:
|
Cynthia M Cely; Roland M H Schein; Andrew A Quartin |
Related Documents
:
|
21775044 - Clinical and cardiac features of patients with subarachnoid haemorrhage presenting with... 21958974 - Impact of high-flow nasal cannula oxygen therapy on intensive care unit patients with a... 1924794 - Transvenous liver biopsy in critically ill patients: adequacy of tissue samples. 7396064 - Interpretation and significance of pathologic findings in transbronchial lung biopsy. 3819454 - Non-gonococcal infectious arthritis: a retrospective study. 21775044 - Clinical and cardiac features of patients with subarachnoid haemorrhage presenting with... |
Publication Detail:
|
Type: JOURNAL ARTICLE Date: 2012-4-25 |
Journal Detail:
|
Title: Critical care (London, England) Volume: 16 ISSN: 1466-609X ISO Abbreviation: - Publication Date: 2012 Apr |
Date Detail:
|
Created Date: 2012-4-26 Completed Date: - Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 9801902 Medline TA: Crit Care Country: - |
Other Details:
|
Languages: ENG Pagination: R67 Citation Subset: - |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
|
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Prognostic factors for visual outcome after intravitreal anti-VEGF injection for naive myopic choroi...
Next Document: Infrared and theoretical calculations in 2-halocycloheptanones conformational analysis.