Acute and long-term renal effects after iodine contrast media–enhanced computerised tomography in the critically ill—a retrospective bi-centre cohort study.
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| Title: | Acute and long-term renal effects after iodine contrast media–enhanced computerised tomography in the critically ill—a retrospective bi-centre cohort study. |
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| Authors: | Berglund, Felix1 (AUTHOR) Felix.Berglund@uu.se, Eilertz, Ebba2 (AUTHOR), Nimmersjö, Fredrik2 (AUTHOR), Wolf, Adam2 (AUTHOR), Nordlander, Christopher2 (AUTHOR), Palm, Fredrik3 (AUTHOR), Parenmark, Fredric4 (AUTHOR), Westerbergh, Johan5 (AUTHOR), Liss, Per1 (AUTHOR), Frithiof, Robert6 (AUTHOR) |
| Source: | European Radiology. Mar2024, Vol. 34 Issue 3, p1736-1745. 10p. |
| Subjects: | Acute kidney failure, Critically ill, Kidney transplantation, Contrast media, Intensive care patients, Iodine |
| Abstract: | Objectives: To determine if current clinical use of iodine contrast media (ICM) for computerised tomography (CT) increases the risk of acute kidney injury (AKI) and long-term decline in renal function in patients treated in intensive care. Methods: A retrospective bi-centre cohort study was performed with critically ill subjects undergoing either ICM-enhanced or unenhanced CT. AKI was defined and staged based on the Kidney Disease Improve Global Outcome AKI criteria, using both creatinine and urine output criteria. Follow-up plasma creatinine was recorded three to six months after CT to assess any long-term effects of ICM on renal function. Results: In total, 611 patients were included in the final analysis, median age was 65.0 years (48.0–73.0, quartile 1–quartile 3 (IQR)) and 62.5% were male. Renal replacement therapy was used post-CT in 12.9% and 180-day mortality was 31.2%. Plasma creatinine level on day of CT was 100.0 µmol/L (66.0–166.5, IQR) for non-ICM group and 77.0 µmol/L (59.0–109.0, IQR) for the ICM group. The adjusted odds ratio for developing AKI if the patient received ICM was 1.03 (95% confidence interval 0.64–1.66, p = 0.90). No significant association between ICM and increase in plasma creatinine at long-term follow-up was found, with an adjusted effect size of 2.92 (95% confidence interval − 6.52–12.36, p = 0.543). Conclusions: The results of this study do not indicate an increased risk of AKI or long-term decline in renal function when ICM is used for enhanced CT in patients treated at intensive care units. Clinical relevance statement: Patients treated in intensive care units had no increased risk of acute kidney injury or persistent decline in renal function after contrast-enhanced CT. This information underlines the need for a proper risk-reward assessment before denying patients a contrast-enhanced CT. Key Points: • Iodine contrast media is considered a risk factor for the development of acute kidney injury. • Patients receiving iodine contrast media did not have an increased incidence of acute kidney injury or persistent decline in renal function. • A more clearly defined risk of iodine contrast media helps guide clinical decisions whether to perform contrast-enhanced CTs or not. [ABSTRACT FROM AUTHOR] |
| Copyright of European Radiology is the property of Springer Nature and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.) | |
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| Items | – Name: Title Label: Title Group: Ti Data: Acute and long-term renal effects after iodine contrast media–enhanced computerised tomography in the critically ill—a retrospective bi-centre cohort study. – Name: Author Label: Authors Group: Au Data: <searchLink fieldCode="AR" term="%22Berglund%2C+Felix%22">Berglund, Felix</searchLink><relatesTo>1</relatesTo> (AUTHOR)<i> Felix.Berglund@uu.se</i><br /><searchLink fieldCode="AR" term="%22Eilertz%2C+Ebba%22">Eilertz, Ebba</searchLink><relatesTo>2</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Nimmersjö%2C+Fredrik%22">Nimmersjö, Fredrik</searchLink><relatesTo>2</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Wolf%2C+Adam%22">Wolf, Adam</searchLink><relatesTo>2</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Nordlander%2C+Christopher%22">Nordlander, Christopher</searchLink><relatesTo>2</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Palm%2C+Fredrik%22">Palm, Fredrik</searchLink><relatesTo>3</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Parenmark%2C+Fredric%22">Parenmark, Fredric</searchLink><relatesTo>4</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Westerbergh%2C+Johan%22">Westerbergh, Johan</searchLink><relatesTo>5</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Liss%2C+Per%22">Liss, Per</searchLink><relatesTo>1</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Frithiof%2C+Robert%22">Frithiof, Robert</searchLink><relatesTo>6</relatesTo> (AUTHOR) – Name: TitleSource Label: Source Group: Src Data: <searchLink fieldCode="JN" term="%22European+Radiology%22">European Radiology</searchLink>. Mar2024, Vol. 34 Issue 3, p1736-1745. 10p. – Name: Subject Label: Subjects Group: Su Data: <searchLink fieldCode="DE" term="%22Acute+kidney+failure%22">Acute kidney failure</searchLink><br /><searchLink fieldCode="DE" term="%22Critically+ill%22">Critically ill</searchLink><br /><searchLink fieldCode="DE" term="%22Kidney+transplantation%22">Kidney transplantation</searchLink><br /><searchLink fieldCode="DE" term="%22Contrast+media%22">Contrast media</searchLink><br /><searchLink fieldCode="DE" term="%22Intensive+care+patients%22">Intensive care patients</searchLink><br /><searchLink fieldCode="DE" term="%22Iodine%22">Iodine</searchLink> – Name: Abstract Label: Abstract Group: Ab Data: Objectives: To determine if current clinical use of iodine contrast media (ICM) for computerised tomography (CT) increases the risk of acute kidney injury (AKI) and long-term decline in renal function in patients treated in intensive care. Methods: A retrospective bi-centre cohort study was performed with critically ill subjects undergoing either ICM-enhanced or unenhanced CT. AKI was defined and staged based on the Kidney Disease Improve Global Outcome AKI criteria, using both creatinine and urine output criteria. Follow-up plasma creatinine was recorded three to six months after CT to assess any long-term effects of ICM on renal function. Results: In total, 611 patients were included in the final analysis, median age was 65.0 years (48.0–73.0, quartile 1–quartile 3 (IQR)) and 62.5% were male. Renal replacement therapy was used post-CT in 12.9% and 180-day mortality was 31.2%. Plasma creatinine level on day of CT was 100.0 µmol/L (66.0–166.5, IQR) for non-ICM group and 77.0 µmol/L (59.0–109.0, IQR) for the ICM group. The adjusted odds ratio for developing AKI if the patient received ICM was 1.03 (95% confidence interval 0.64–1.66, p = 0.90). No significant association between ICM and increase in plasma creatinine at long-term follow-up was found, with an adjusted effect size of 2.92 (95% confidence interval − 6.52–12.36, p = 0.543). Conclusions: The results of this study do not indicate an increased risk of AKI or long-term decline in renal function when ICM is used for enhanced CT in patients treated at intensive care units. Clinical relevance statement: Patients treated in intensive care units had no increased risk of acute kidney injury or persistent decline in renal function after contrast-enhanced CT. This information underlines the need for a proper risk-reward assessment before denying patients a contrast-enhanced CT. Key Points: • Iodine contrast media is considered a risk factor for the development of acute kidney injury. • Patients receiving iodine contrast media did not have an increased incidence of acute kidney injury or persistent decline in renal function. • A more clearly defined risk of iodine contrast media helps guide clinical decisions whether to perform contrast-enhanced CTs or not. [ABSTRACT FROM AUTHOR] – Name: AbstractSuppliedCopyright Label: Group: Ab Data: <i>Copyright of European Radiology is the property of Springer Nature and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.) |
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| RecordInfo | BibRecord: BibEntity: Identifiers: – Type: doi Value: 10.1007/s00330-023-10059-7 Languages: – Code: eng Text: English PhysicalDescription: Pagination: PageCount: 10 StartPage: 1736 Subjects: – SubjectFull: Acute kidney failure Type: general – SubjectFull: Critically ill Type: general – SubjectFull: Kidney transplantation Type: general – SubjectFull: Contrast media Type: general – SubjectFull: Intensive care patients Type: general – SubjectFull: Iodine Type: general Titles: – TitleFull: Acute and long-term renal effects after iodine contrast media–enhanced computerised tomography in the critically ill—a retrospective bi-centre cohort study. Type: main BibRelationships: HasContributorRelationships: – PersonEntity: Name: NameFull: Berglund, Felix – PersonEntity: Name: NameFull: Eilertz, Ebba – PersonEntity: Name: NameFull: Nimmersjö, Fredrik – PersonEntity: Name: NameFull: Wolf, Adam – PersonEntity: Name: NameFull: Nordlander, Christopher – PersonEntity: Name: NameFull: Palm, Fredrik – PersonEntity: Name: NameFull: Parenmark, Fredric – PersonEntity: Name: NameFull: Westerbergh, Johan – PersonEntity: Name: NameFull: Liss, Per – PersonEntity: Name: NameFull: Frithiof, Robert IsPartOfRelationships: – BibEntity: Dates: – D: 01 M: 03 Text: Mar2024 Type: published Y: 2024 Identifiers: – Type: issn-print Value: 09387994 Numbering: – Type: volume Value: 34 – Type: issue Value: 3 Titles: – TitleFull: European Radiology Type: main |
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