Avaliação dos níveis de creatinina em pacientes submetidos à tomografia contrastada: uma metanálise

Abstract

Resumo A variação do valor encontrado nos exames de creatinina em pacientes submetidos à tomografia computadorizada (TC) contrastada tem sido utilizada como método prático para a avaliação de possíveis lesões renais causadas pelo uso do contraste. Entre os critérios, considera-se o aumento absoluto de creatinina sérica ≥ 0,5 mg/dL ou relativo em ≥ 25% para possíveis distúrbios renais, como a nefropatia induzida por contraste (NIC). Nosso objetivo foi analisar a incidência de NIC através de uma metanálise envolvendo nove artigos relacionados à incidência de lesão renal por contraste, sendo calculado o odds ratio (OR) e o intervalo de confiança (IC95%) por meio do programa RStudio. A incidência de NIC em pacientes submetidos a TC foi de 11,29%, sendo o OR de 1,38 (IC95% 0,88–2,16). Contrastes não iônicos apresentam maior segurança em seu uso que outros tipos de contraste, e o volume maior que 115 mL pode estar relacionado a NIC. A doença renal prévia apresentou significado estatístico em agravar a NIC.

Evaluation of Brain Natriuretic Peptide as a Predictor of Contrast Induced Acute Kidney Injury Post Percutaneous Coronary Intervention in Patients with Acute Coronary Syndrome

“…The majority of cases were males (60 %). The studied patients were divided according to development of contrast-induced nephropathy (CIN) which is 50% rise in serum creatinine from baseline or an increase of 0.3 mg/dL within 48-72 hours following intravenous contrast administration [8] into two groups; group (A) involved 33 cases who developed contrast-induced nephropathy and group (B) involved 27 cases who did not develop contrast-induced nephropathy. Age was significantly higher in CIN group compared to group B (p= 0.006).…”

SGLT-2 inhibitors and prevention of contrast-induced nephropathy in patients with diabetes undergoing coronary angiography and percutaneous coronary interventions: systematic review and meta-analysis

“…The criteria initially proposed by Barrett and Parfrey defined CIN as an absolute increase in serum creatinine levels by ≥0.5 mg/dL or a relative increase in serum creatinine by ≥25% from baseline within 72 hours after contrast exposure ( 34 ). In a recent meta-analysis, definitions of CIN based on serum creatinine levels ranged from 0.3 to 0.5 mg/dL for an absolute increase and 25 to 50% for a relative increase within 48-72 hours following intravenous contrast administration ( 35 ). Consequently, in this systematic review, we considered a patient to have CIN if they met any of the above definitions.…”

ST segment yükselmeli miyokard enfarktüsü olan hastalarda kontrast maddeye bağlı nefropati ile CANLPH skoru arasındaki ilişki

“…Hypotension was defined as systolic blood pressure of <80 mmHg for at least 1 h necessitating inotropic support with drugs or an intra-aortic balloon pump within 24 h following the procedure. CIN was defined as a 25% or 0.5 mg/dL increase in serum creatinine compared to the baseline value within 48 h after PCI (16). The primary endpoint was defined as the development of CIN and the secondary endpoint was inhospital mortality.…”