Abstract
Background: Although several studies have examined contrast-induced nephropathy (CIN) following computed tomography (CT) procedures under closely controlled clinical trial conditions, less is known about the incidence of CIN (or its key predictive factors) in a "real world" clinical setting. Purpose: A multicenter, observational registry study was undertaken in Italian hospital radiology departments to retrospectively assess the incidence of CIN in at-risk patients undergoing iodixanol-enhanced CT procedures. Material and Methods: Each department used center-specific (nonstandardized) CT protocols. Data were available from 493 at-risk patients; most (76.4%) had 1 risk factor for CIN, 19.8% had 2, and 3.4% had 3. In all, 169 patients (34.3%) had reduced renal function (estimated glomerular filtration rate [eGFR] 2). Prophylactic volume expansion was not used in 70.6% of the study population. Results: The overall incidence of CIN (defined as a ≥44.2 μmol/l [0.5 mg/dl] increase in serum creatinine from baseline 72 h postprocedure) was 2.6%; in the subpopulation of patients with renal impairment (with or without other risk factors), CIN incidence was 4.7%. Multivariate analysis identified renal insufficiency as the only risk factor predictive of CIN (relative risk, 3.850; 95% confidence interval, 1.20012.348; P0.023). Conclusion: In the clinical setting of hospital CT radiology practice, where guideline-recommended strategies for CIN prevention may not be consistently followed, use of the iso-osmolar agent iodixanol appears to be associated with a low incidence of CIN in at-risk patients.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 741-750 |
| Number of pages | 10 |
| Journal | Acta Radiologica |
| Volume | 51 |
| Issue number | 7 |
| DOIs | |
| State | Published - Sep 2010 |
| Externally published | Yes |
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Keywords
- CT
- Intravenous contrast agents
- Kidney
- Vascular
ASJC Scopus subject areas
- Radiology Nuclear Medicine and imaging
- Radiological and Ultrasound Technology
- Medicine(all)
Cite this
Contrast-induced nephropathy in patients undergoing computed tomography (CONNECT) - A clinical problem in daily practice? A multicenter observational study. / Lencioni, Riccardo; Fattori, Rossella; Morana, Giovanni; Stacul, Fulvio.
In: Acta Radiologica, Vol. 51, No. 7, 09.2010, p. 741-750.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Contrast-induced nephropathy in patients undergoing computed tomography (CONNECT) - A clinical problem in daily practice? A multicenter observational study
AU - Lencioni, Riccardo
AU - Fattori, Rossella
AU - Morana, Giovanni
AU - Stacul, Fulvio
PY - 2010/9
Y1 - 2010/9
N2 - Background: Although several studies have examined contrast-induced nephropathy (CIN) following computed tomography (CT) procedures under closely controlled clinical trial conditions, less is known about the incidence of CIN (or its key predictive factors) in a "real world" clinical setting. Purpose: A multicenter, observational registry study was undertaken in Italian hospital radiology departments to retrospectively assess the incidence of CIN in at-risk patients undergoing iodixanol-enhanced CT procedures. Material and Methods: Each department used center-specific (nonstandardized) CT protocols. Data were available from 493 at-risk patients; most (76.4%) had 1 risk factor for CIN, 19.8% had 2, and 3.4% had 3. In all, 169 patients (34.3%) had reduced renal function (estimated glomerular filtration rate [eGFR] 2). Prophylactic volume expansion was not used in 70.6% of the study population. Results: The overall incidence of CIN (defined as a ≥44.2 μmol/l [0.5 mg/dl] increase in serum creatinine from baseline 72 h postprocedure) was 2.6%; in the subpopulation of patients with renal impairment (with or without other risk factors), CIN incidence was 4.7%. Multivariate analysis identified renal insufficiency as the only risk factor predictive of CIN (relative risk, 3.850; 95% confidence interval, 1.20012.348; P0.023). Conclusion: In the clinical setting of hospital CT radiology practice, where guideline-recommended strategies for CIN prevention may not be consistently followed, use of the iso-osmolar agent iodixanol appears to be associated with a low incidence of CIN in at-risk patients.
AB - Background: Although several studies have examined contrast-induced nephropathy (CIN) following computed tomography (CT) procedures under closely controlled clinical trial conditions, less is known about the incidence of CIN (or its key predictive factors) in a "real world" clinical setting. Purpose: A multicenter, observational registry study was undertaken in Italian hospital radiology departments to retrospectively assess the incidence of CIN in at-risk patients undergoing iodixanol-enhanced CT procedures. Material and Methods: Each department used center-specific (nonstandardized) CT protocols. Data were available from 493 at-risk patients; most (76.4%) had 1 risk factor for CIN, 19.8% had 2, and 3.4% had 3. In all, 169 patients (34.3%) had reduced renal function (estimated glomerular filtration rate [eGFR] 2). Prophylactic volume expansion was not used in 70.6% of the study population. Results: The overall incidence of CIN (defined as a ≥44.2 μmol/l [0.5 mg/dl] increase in serum creatinine from baseline 72 h postprocedure) was 2.6%; in the subpopulation of patients with renal impairment (with or without other risk factors), CIN incidence was 4.7%. Multivariate analysis identified renal insufficiency as the only risk factor predictive of CIN (relative risk, 3.850; 95% confidence interval, 1.20012.348; P0.023). Conclusion: In the clinical setting of hospital CT radiology practice, where guideline-recommended strategies for CIN prevention may not be consistently followed, use of the iso-osmolar agent iodixanol appears to be associated with a low incidence of CIN in at-risk patients.
KW - CT
KW - Intravenous contrast agents
KW - Kidney
KW - Vascular
UR - http://www.scopus.com/inward/record.url?scp=77955693583&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=77955693583&partnerID=8YFLogxK
U2 - 10.3109/02841851.2010.495350
DO - 10.3109/02841851.2010.495350
M3 - Article
C2 - 20707658
AN - SCOPUS:77955693583
VL - 51
SP - 741
EP - 750
JO - Acta Radiologica
JF - Acta Radiologica
SN - 0284-1851
IS - 7
ER -