Intravenous albumin for the prevention of contrast-induced nephropathy in patients with liver cirrhosis and chronic kidney disease undergoing contrast-enhanced CT

Choi, Heejung; Kim, Yoonjung; Kim, Soo Min; Shin, Junam; Jang, Hye Ryoun; Lee, Jung Eun; Huh, Wooseong; Kim, Yoon Goo; Oh, Ha Young; Kim, Dae Joong

Abstract

BACKGROUND
The purpose of this study was to evaluate the incidence of contrast-induced nephropathy (CIN), and the effect of intravenous albumin for prophylaxis of CIN in patients with liver cirrhosis (LC) and chronic kidney disease (CKD).
METHODS
We conducted a retrospective study of 81 subjects with LC and CKD (estimated glomerular filtration rate (eGFR)<60mL/min/1.73m2) who underwent contrast-enhanced computed tomography (CT). Patients received either isotonic sodium bicarbonate solution (3mL/kg for 1h before CT and 1mL/kg/h for 6h after CT) or albumin (20% albumin, 25mL for 1h before CT and 75mL for 6h after CT). CIN was defined as an increase of > or =25% or > or =0.5mg/dL in serum creatinine level.
RESULTS
Overall, CIN developed in three patients (3.7%). Of the 81 subjects, 43 received sodium bicarbonate solution and 38 received albumin. Both groups were comparable with regard to age, sex, diabetes mellitus, and baseline eGFR. The albumin group showed a significantly poorer liver function profile. CIN incidence did not differ significantly between the groups: it occurred in one (2.3%) of the 43 subjects receiving sodium bicarbonate and two (5.3%) of the 38 subjects receiving albumin (P=0.6). However, the albumin group showed a significantly smaller increase in body weight (P=0.03).
CONCLUSION
The incidence of CIN in patients with LC and CKD undergoing contrast-enhanced CT after preventive measures was relatively low. The incidence of CIN was not significantly different between sodium bicarbonate and albumin groups.