Frequency of Acute Kidney Injury Following Intravenous Contrast Medium Administration: A Systematic Review and Meta-Analysis

McDonald, Jennifer S.; McDonald, Robert J.; Comin, Jules; Williamson, Eric E.; Katzberg, Richard W.; Murad, M. Hassan; Kallmes, David F.

doi:10.1148/radiol.12121460

Cited by 351 publications

(248 citation statements)

References 51 publications

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“…Meta-analysis of 13 studies in which incidence of AKI was directly compared between patients who were and were not exposed to CM failed to demonstrate any increased risk of AKI, dialysis, or death associated with CM [9]. This is supported by a recent nationwide analysis of administrative data for almost 6 million patients in the USA, where rates of AKI were nearly identical in patients who did and did not receive CM [10].…”

Section: Intravenous Contrast Media and Acute Kidney Injury In The Gementioning

confidence: 91%

Contrast-associated acute kidney injury is a myth: Yes

2017

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Section: Intravenous Contrast Media and Acute Kidney Injury In The Gementioning

confidence: 91%

Contrast-associated acute kidney injury is a myth: Yes

2017

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“…Therefore, the existence of a causal relationship is not clear. In a systematic review/meta‐analysis performed in 2013, McDonald et al .,42 found that the relative risk (RR) of acute kidney injury (AKI) development, requiring intermittent hemodialysis, and mortality were 0.79, 0.88, 0.95, respectively, and no significant differences were observed (15582 patients exposed to contrast agents, 10368 patients not exposed.). Ng et al 43.…”

Section: Introductionmentioning

confidence: 99%

The Japanese Clinical Practice Guidelines for Management of Sepsis and Septic Shock 2016 (J‐SSCG2016)

Nishida

Ogura

Egi

et al. 2018

Acute Medicine & Surgery

157

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Background and PurposeThe Japanese Clinical Practice Guidelines for Management of Sepsis and Septic Shock 2016 (J‐SSCG 2016), a Japanese‐specific set of clinical practice guidelines for sepsis and septic shock created jointly by the Japanese Society of Intensive Care Medicine and the Japanese Association for Acute Medicine, was first released in February 2017 in Japanese. An English‐language version of these guidelines was created based on the contents of the original Japanese‐language version.MethodsMembers of the Japanese Society of Intensive Care Medicine and the Japanese Association for Acute Medicine were selected and organized into 19 committee members and 52 working group members. The guidelines were prepared in accordance with the Medical Information Network Distribution Service (Minds) creation procedures. The Academic Guidelines Promotion Team was organized to oversee and provide academic support to the respective activities allocated to each Guideline Creation Team. To improve quality assurance and workflow transparency, a mutual peer review system was established, and discussions within each team were open to the public. Public comments were collected once after the initial formulation of a clinical question (CQ), and twice during the review of the final draft. Recommendations were determined to have been adopted after obtaining support from a two‐thirds (>66.6%) majority vote of each of the 19 committee members.ResultsA total of 87 CQs were selected among 19 clinical areas, including pediatric topics and several other important areas not covered in the first edition of the Japanese guidelines (J‐SSCG 2012). The approval rate obtained through committee voting, in addition to ratings of the strengths of the recommendation and its supporting evidence were also added to each recommendation statement. We conducted meta‐analyses for 29 CQs. Thirty seven CQs contained recommendations in the form of an expert consensus due to insufficient evidence. No recommendations were provided for 5 CQs.ConclusionsBased on the evidence gathered, we were able to formulate Japanese‐specific clinical practice guidelines that are tailored to the Japanese context in a highly transparent manner. These guidelines can easily be used not only by specialists, but also by non‐specialists, general clinicians, nurses, pharmacists, clinical engineers, and other healthcare professionals.

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“…Contrast-enhanced computed tomography (CT) is the gold standard for diagnosis and assessment of severity of acute pyelonephritis (APN) and its complications [6]; it is however burdened by the well-known risk of contrast medium-induced nephropathy [7][8][9] CEUS has been shown to perform well in the diagnosis of APN for both native and transplanted kidneys [10,11], but its use requires specific expertise not so widely diffused. Magnetic resonance imaging (MRI) is indicated for patients with contraindications to iodinated contrast media such as transplant recipients.…”

mentioning

confidence: 99%

Acute pyelonephritis in transplanted kidneys: can diffusion-weighted magnetic resonance imaging be useful for diagnosis and follow-up?

et al. 2016

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Purpose: To assess reliability of diffusion-weighted magnetic resonance imaging (DW-MRI) in the management of acute pyelonephritis (APN) foci in transplanted kidneys. Materials and methods: In the 2012-2014 period, 24 kidney-transplanted patients underwent MR screening for clinical suspicion of APN. Two readers independently analyzed all images, establishing presence and location of APN foci. The 22 patients who were positive at the MR exam constituted the study population. For each patient the apparent diffusion coefficient (ADC) was measured in the APN foci and in three sites of the healthy parenchyma (case-control comparison). The data were matched to the laboratory measurements for white blood cell, C-reactive protein, and serum creatinine. Results: Forty-six APN foci were found in 22/24 patients. At the acute stage, the difference in ADC between healthy parenchyma and APN foci was significant (2.06 ± 0.16 vs. 1.43 ± 0.32 9 10 -3 mm 2 /s; p < 0.0001). The performance of ADC as APN indicator was tested by the receiving operating characteristics (ROC) curve: the area under curve AUC = 0.99 witnessed an excellent discriminatory ability, with threshold APN/normal parenchyma 1.9 9 10 -3 mm 2 /s. At the 1-month follow-up 43/46 APN foci were no longer visible, with ADC values significantly higher than at the acute stage; all laboratory data were physiological, with WBC significantly reduced from the acute phase (5.2 ± 1.6 9 10 9 /L vs. 10.6 ± 4.8 9 10 9 /L; p < 0.0001). The other 3 patients underwent further therapy and exams, including a third MR.Conclusions: DW-MRI with ADC measurement seems to be a reliable tool in diagnosing and monitoring APN foci in transplanted kidneys, with clinical impact on patient management.

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Frequency of Acute Kidney Injury Following Intravenous Contrast Medium Administration: A Systematic Review and Meta-Analysis

Abstract: http://radiology.rsna.org/lookup/suppl/doi:10.1148/radiol.12121460/-/DC1.

Cited by 351 publications

References 51 publications

Contrast-associated acute kidney injury is a myth: Yes

Contrast-associated acute kidney injury is a myth: Yes

The Japanese Clinical Practice Guidelines for Management of Sepsis and Septic Shock 2016 (J‐SSCG2016)

Acute pyelonephritis in transplanted kidneys: can diffusion-weighted magnetic resonance imaging be useful for diagnosis and follow-up?

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