Acute Kidney Injury After Computed Tomography: A Meta-analysis

Perioperative intravenous contrast administration and the incidence of acute kidney injury after major gastrointestinal surgery: prospective, multicentre cohort study

“…Contrary to longstanding concerns regarding the risk of contrast‐induced nephropathy, this large prospective, multicentre study found no association between either preoperative or postoperative exposure to contrast and AKI. This finding is consistent with recent large registry‐based studies. The present study was more broadly generalizable than previous analyses, which have been based predominantly on smaller or retrospective data sets.…”

“…Contrast‐induced nephropathy is the third most common cause of AKI, accounting for 10 per cent of inpatient AKI. However, both large registry‐based analyses and systematic reviews have found no association between exposure to intravenous iodinated contrast and AKI. Nevertheless, concerns persist in the surgical setting owing to the physiological insult of surgery potentially predisposing patients to the risk of contrast media, acting as a second hit that leads to AKI.…”

The continuing evolution of COVID-19 imaging pathways in the UK: a British Society of Thoracic Imaging expert reference group update

“…Although there will be understandable concerns of contrast-induced nephropathy, a recent meta-analysis of 28 studies and 107,335 participants found no significant differences in AKI, need for renal replacement therapy, or allcause mortality between patients receiving contrastenhanced CT versus those receiving unenhanced CT, suggesting other patient and illness factors, rather than contrast material are likely to contribute to AKI. 22 It should be noted that patients with COVID-19, or suspected COVID-19, requiring high-flow nasal cannula oxygen delivery or non-invasive ventilation pose a risk of aerosolisation. 23 Transferring such patients to radiology departments for CTPA would have implications for infection control and cleaning as per local institutional policy.…”

The fear for contrast-induced nephropathy in kidney transplant recipients: time for a paradigm shift?

“…Increase in sCr of ≥0.5 or ≥25% drop in eGFR graft catheter arteriography, and 12.5% after endovascular aortic aneurysm repair (Table 1) [3][4][5][6][7]. This, compared to the most recent meta-analysis on CIN in the general population, reporting a 7.2% incidence of CIN after iodinated contrast CT [8]. Even though the studies with KTRs are small and retrospective, based on these data, the Contrast Medium Safety Committee of the European Society of Urogenital Radiology, concluded that there is insufficient evidence to substantiate a higher incidence of CIN in KTRs than in the nontransplant population [9].…”