Radiology departmental policy compliance with Swedish guidelines regarding post-contrast acute kidney injury for examinations with iodinated contrast media

Bjällmark, Anna; Bazzi, May; Karlsson, Magnus K.; Krakys, E.; Kihlberg, Johan

doi:10.1016/j.radi.2021.04.009

Cited by 1 publication

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References 29 publications

(33 reference statements)

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“…The American College of Radiology (ACR) also proposes that individual patient’s condition and associated risk factor(s) should be taken into consideration before using contrast media [ 3 ]. Therefore, in order to identify patients at high risk of PC-AKI, the measurement of eGFR, a hematologic marker of renal function, is suggested to be implemented before the administration of contrast media [ 1 , 2 , 5 , 12 , 13 ]. However, few studies have evaluated renal function over time, and the timing of eGFR test prior to contrast-enhanced CT has not been standardized.…”

Section: Introductionmentioning

confidence: 99%

Changes in renal function over time in outpatients with eGFR ≥ 30 mL/min/1.73 m2: implication for timing of renal function testing before contrast-enhanced CT imaging

et al. 2023

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Purpose To evaluate the associations between comorbidities and kidney function decline at 6-month and 1-year follow-up in outpatients with initial estimated glomerular filtration rate (eGFR) ≥ 30 mL/min/1.73 m2. Materials and methods Outpatients aged 18 and older with confirmed diagnosis, who had eGFR ≥ 30 mL/min/1.73 m2 measured between April 2017 and March 2019, were included in this retrospective observational study. Of them, 30,595 included outpatients had 6-month eGFR test and 27,698 included outpatients had 1-year eGFR test. The outpatients were further divided into two groups based on initial eGFR: between 30 and 59 and ≥ 60 mL/min/1.73 m2. Impaired renal function was defined as eGFR declined to below 30 mL/min/1.73 m2. The comorbidities with P values less than 0.1 identified in univariable logistic regression models were entered into the multivariable analysis with backward selection, thereby identifying comorbidities that increased the risk of eGFR decline at 6-month and 1-year follow-up. Results Outpatients with initial eGFR between 30 and 59 mL/min/1.73 m2 were 175.94 times more likely to have eGFR decline at 6 months, and were 94.10 times more likely to have eGFR decline at 1 year, compared with their corresponding initial eGFR ≥ 60 counterparts. Multivariable logistic regression analyses disclosed that chronic kidney disease, hypertension, and heart failure were independent risk factors for eGFR decline in outpatients with initial eGFR between 30 and 59 mL/min/1.73 m2. Conclusions Outpatients with initial eGFR ≥ 60 mL/min/1.73 m2 might not need routine eGFR test prior to contrast-enhanced CT scan for 1 year. In addition, chronic kidney disease, hypertension, and heart failure increased the risk of declined renal function, particularly, in outpatients with initial eGFR between 30 and 59 mL/min/1.73 m2.

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