Incidence of contrast-induced nephropathy after a computed tomography scan

Lopez, Amada; Martinez, Frank; Rodrı́guez, José Ignacio; Montero-San-Martin, Blanca; Rioja, Rubén Gómez; Jj, Díez; Martín-Hervás, C.

doi:10.1016/j.rxeng.2020.02.005

Cited by 8 publications

(7 citation statements)

References 33 publications

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“…We considered the patients with estimated glomerular filtration rate (eGFR) below 45 mL/min/1.73 m 2 as high-risk patients to develop CIN, whereas patients showing eGFR of 45 mL/min/1.73 m 2 or more are considered low-risk patients. 6 As a conclusion, we found that the majority of our study participants were low-risk patients (88%). In our study, one-half of the population (50%; n = 50) was administered IVF along with NAC as a pharmacological management of CIN and the remaining half (50%; n = 50) was administered IVF alone.…”

Section: Resultsmentioning

confidence: 49%

Therapeutic Benefits of N-Acetylcysteine in the Management of Contrast-Induced Nephropathy

Velusamy,

Parthasarathy,

Jayakumar

et al. 2024

Journal of Health and Allied Sciences NU

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Objective This study aimed to assess the beneficial effects of N-acetylcysteine (NAC) in the treatment of contrast-induced nephropathy (CIN). Materials and Methods A prospective study was conducted in the department of cardiology of a tertiary health care hospital. A sample of 100 patients who had developed CIN through coronary angioplasty were categorized into two groups: one group treated with intravenous fluids (IVF) monotherapy and the other group treated with the combination of IVF and NAC therapy. Statistical Analysis The data were analyzed using statistical software SPSS software version 26 and statistical significance was set at p < 0.05. Independent t-test and paired t-test were used to analyze the parameters. Results The rate of incidence of CIN was found to be 10%. We observed that the IVF + NAC combination therapy significantly decreases the serum creatinine compared to IVF monotherapy (p = 0.004). Both therapies show similar treatment outcomes with no significant difference (p = 0.556) in the case of estimated glomerular filtration rate (eGFR). Based on creatinine clearance, the results show adding NAC does not impact any additional benefits (p = 000). The duration of hospital stay of the NAC group was reduced significantly (p = 0.000). Conclusion At present, we found that the treatment outcomes which we analyzed based on factors such as serum creatinine, eGFR, and creatinine clearance, are too inconsistent to conclude the beneficial effect of NAC in the management of CIN.

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Section: Resultsmentioning

confidence: 49%

Therapeutic Benefits of N-Acetylcysteine in the Management of Contrast-Induced Nephropathy

Velusamy,

Parthasarathy,

Jayakumar

et al. 2024

Journal of Health and Allied Sciences NU

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“…Two meta-analysis including around 19,000 patients who had received intravenous contrast media showed CA-AKI incidences of 5.0% and 6.4% [21,22], significantly lower than previously thought. Furthermore, a recent study has reported an incidence of CA-AKI as low as 0.9% among patients with moderate CKD after a CE-CT scan [3]. Current procedures using minimum volume, non-ionic contrast material might explain why the CA-AKI incidence is low, even in high-risk patients [10,23].…”

Section: Discussionmentioning

confidence: 99%

“…The incidence of CA-AKI in the overall population undergoing a CE-CT scan is generally low, but may increase when some conditions are present, such as aging, diabetes, or previous renal impairment [3,4]. CA-AKI is associated with renal failure, longer hospital stays, and mortality [5].…”

Section: Introductionmentioning

confidence: 99%

Oral Sodium Chloride in the Prevention of Contrast-Associated Acute Kidney Injury in Elderly Outpatients: The PNIC-Na Randomized Non-Inferiority Trial

Cervantes

Fabregate

López-Rodríguez

et al. 2023

JCM

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Objective: We aimed to test the non-inferiority of oral versus intravenous hydration in the incidence of contrast-associated acute kidney injury (CA-AKI) in elderly outpatients undergoing a contrast-enhanced computed tomography (CE-CT) scan. Methods: PNIC-Na (NCT03476460) is a phase-2, single-center, randomized, open-label, non-inferiority trial. We included outpatients undergoing a CE-CT scan, >65 years having at least one risk factor for CA-AKI, such as diabetes, heart failure, or an estimated glomerular filtration rate (eGFR) of 30–59 mL/min/1.73 m². Participants were randomized (1:1) to oral sodium-chloride capsules or intravenous hydration. The primary outcome was an increase in serum creatinine >0.3 mg/dL or a reduction in eGFR >25% within 48 h. The non-inferiority margin was set at 5%. Results: A total of 271 subjects (mean age 74 years, 66% male) were randomized, and 252 were considered for the main analysis (per-protocol). A total of 123 received oral hydration and 129 intravenous. CA-AKI occurred in 9 (3.6%) of 252 patients and 5/123 (4.1%) in the oral-hydration group vs. 4/129 (3.1%) in the intravenous-hydration group. The absolute difference between the groups was 1.0% (95% CI −4.8% to 7.0%), and the upper limit of the 95% CI exceeded the pre-established non-inferiority margin. No major safety concerns were observed. Conclusion: The incidence of CA-AKI was lower than expected. Although both regimens showed similar incidences of CA-AKI, the non-inferiority was not shown.

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“…Studies have indicated that the high dose of contrast medium (CM) contributed signi cantly to the diagnostically acceptable CCTA [3,4]. However, high CM dose on patients with poor glomerular ltration rate would more likely cause contrast-induced nephropathy (CIN) [5][6][7][8]. Therefore, the use of low CM in CCTA have signi cant clinical value, especially in patients with renal failure.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of image quality on low contrast media with deep learning image reconstruction algorithm in prospective ECG-triggering coronary CT angiography

Yuan,

Wang,

Lyu

et al. 2024

Int J Cardiovasc Imaging

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Purpose To assess the impact of low-dose contrast medium (CM) injection protocol with deep learning image reconstruction (DLIR) algorithm on image quality in coronary CT angiography (CCTA).Methods and Materials 210 patients undergoing CCTA were prospectively and randomly assigned to three groups with different contrast volume protocols (at 320mgI/mL concentration and constant ow rate of 5ml/s): Group A, 0.7mL/kg (n = 70); Group B, 0.6mL/kg (n = 70); Group C, 0.5mL/kg (n = 70). All patients were examined via a prospective ECG-triggered scan protocol within one heartbeat. A high level DLIR (DLIR-H) algorithm was used for image reconstruction with a thickness and interval of 0.625mm. The CT values of ascending aorta (AA), descending aorta (DA), three main coronary arteries, pulmonary artery (PA), and superior vena cava (SVC) were measured and analyzed for objective assessment. Two radiologists assessed the image quality and diagnostic con dence using a 5-point Likert scale. ResultsThe CM doses were 46.81 ± 6.41mL, 41.96 ± 7.51mL and 34.65 ± 5.38mL for Group A, B and C, respectively. The objective assessments on AA, DA and the three main coronary arteries and the overall subjective scoring showed no difference among the three groups (all p > 0.05). Group A had higher enhancements in PA and SVC than groups B and C (all p < 0.05).Conclusions CCTA reconstructed with DLIR could be realized with adequate enhancement in coronary arteries, excellent image quality and diagnostic con dence at low contrast dose of 0.5mL/kg. The use of lower tube voltages may further reduce the contrast dose requirement.

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Incidence of contrast-induced nephropathy after a computed tomography scan

Cited by 8 publications

References 33 publications

Therapeutic Benefits of N-Acetylcysteine in the Management of Contrast-Induced Nephropathy

Therapeutic Benefits of N-Acetylcysteine in the Management of Contrast-Induced Nephropathy

Oral Sodium Chloride in the Prevention of Contrast-Associated Acute Kidney Injury in Elderly Outpatients: The PNIC-Na Randomized Non-Inferiority Trial

Evaluation of image quality on low contrast media with deep learning image reconstruction algorithm in prospective ECG-triggering coronary CT angiography

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