“…Neither study accounted for other causes of AKI nor did they compare with controls [9, 10]. To our knowledge, this is the first study to compare the incidence of post-CT AKI in elderly patients who received IV ICM with controls who had nonenhanced examinations.…”
Section: Resultsmentioning
confidence: 99%
“…The use of CT in clinical medicine has exponentially increased over the past two decades, including managing elderly patients, who are thought to be particularly susceptible to developing CIN [7–10]. The true incidence of CIN in the elderly is not known, as most studies addressing the issue assumed that acute kidney injury (AKI) following ICM administration is in fact CIN [11–13].…”
Background. Contrast-induced nephropathy (CIN) is a recognised complication of intravascular administration of iodinated contrast media (ICM). Previous studies suggest a higher incidence in the elderly, but no large study has assessed this to date. We set out to assess changes in creatinine in elderly inpatients following computed tomography (CT) examination and compare those who received intravenous contrast to those who did not. Methods. Using the Radiology Information System in two teaching hospitals, inpatients over the age of seventy who had a CT examination and a baseline creatinine were identified and their follow-up creatinine levels were analysed. Elderly inpatients who underwent a noncontrast CT over the same period were used as controls. Results. 677 elderly inpatients who received ICM were compared with 487 controls. 9.2% of patients who received ICM developed acute kidney injury (AKI) compared to 3.5% of inpatient controls (P < 0.0001). Patients with higher baseline eGFR had a higher incidence of post-CT AKI. Conclusions. The incidence of post-CT AKI is higher in patients who received IV ICM compared to those who did not; the difference may be partly attributable to contrast-induced nephropathy. This suggests that the incidence of CIN in the elderly may not be as high as previously thought.
“…Neither study accounted for other causes of AKI nor did they compare with controls [9, 10]. To our knowledge, this is the first study to compare the incidence of post-CT AKI in elderly patients who received IV ICM with controls who had nonenhanced examinations.…”
Section: Resultsmentioning
confidence: 99%
“…The use of CT in clinical medicine has exponentially increased over the past two decades, including managing elderly patients, who are thought to be particularly susceptible to developing CIN [7–10]. The true incidence of CIN in the elderly is not known, as most studies addressing the issue assumed that acute kidney injury (AKI) following ICM administration is in fact CIN [11–13].…”
Background. Contrast-induced nephropathy (CIN) is a recognised complication of intravascular administration of iodinated contrast media (ICM). Previous studies suggest a higher incidence in the elderly, but no large study has assessed this to date. We set out to assess changes in creatinine in elderly inpatients following computed tomography (CT) examination and compare those who received intravenous contrast to those who did not. Methods. Using the Radiology Information System in two teaching hospitals, inpatients over the age of seventy who had a CT examination and a baseline creatinine were identified and their follow-up creatinine levels were analysed. Elderly inpatients who underwent a noncontrast CT over the same period were used as controls. Results. 677 elderly inpatients who received ICM were compared with 487 controls. 9.2% of patients who received ICM developed acute kidney injury (AKI) compared to 3.5% of inpatient controls (P < 0.0001). Patients with higher baseline eGFR had a higher incidence of post-CT AKI. Conclusions. The incidence of post-CT AKI is higher in patients who received IV ICM compared to those who did not; the difference may be partly attributable to contrast-induced nephropathy. This suggests that the incidence of CIN in the elderly may not be as high as previously thought.
“…People over 75 years of age represent a specific group of patients for which the clinician is often in doubt as to what to do, whether additional diagnostic workup is helpful or a primary medical approach would suffice. However, this patient population is less prone to the long-term effects of radiation burden or contrast medium-induced nephropathy [6], and therefore it may be especially worthwhile to use advanced imaging techniques such as contrast-enhanced CT in these patients. The following cases illustrate two common diagnostic problems, in which coronary CT angiography decided the clinical course.Fig.…”
People over 75 years of age represent a specific group of patients for which the clinician is often in doubt about what to do, whether additional diagnostic workup is helpful or a primary medical approach would suffice. However, this patient population is less prone to the long-term effects of radiation burden or contrast medium-induced nephropathy, and therefore it may be especially worthwhile to use advanced imaging techniques such as contrast-enhanced CT in these patients. The following cases illustrate two common diagnostic problems, in which coronary CT angiography decided the clinical course.
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