Korean J Radiol.  2014 Aug;15(4):456-463. 10.3348/kjr.2014.15.4.456.

Contrast-Induced Nephropathy in Patients Undergoing Intravenous Contrast-Enhanced Computed Tomography in Korea: A Multi-Institutional Study in 101487 Patients

• Lee J
• Cho JY
• Lee HJ
• Jeong YY
• Kim CK
• Park BK
• Sung DJ
• Kang BC
• Jung SI
• Lee EJ
• Yi BH
• Park SJ
• Kim JC
• Jung DC
• Sung CK
• Kim Y
• Lee Y
• Kim SH
• Yoon SK
• Park BJ
• Kim SH
• Korean Society of Urogenital Radiology (KSUR)
• Korean Society of Radiology

• KMID: 1731049
• DOI: http://doi.org/10.3348/kjr.2014.15.4.456

Abstract

OBJECTIVE
To evaluate the prevalence of known risk factors for contrast-induced nephropathy (CIN) and their association with the actual occurrence of CIN in patients undergoing intravenous contrast-enhanced computed tomography (CECT) in Korea.
MATERIALS AND METHODS
Patients who underwent CECT in 2008 were identified in the electronic medical records of 16 tertiary hospitals of Korea. Data on demographics, comorbidities, prescriptions and laboratory test results of patients were collected following a standard data extraction protocol. The baseline renal function was assessed using the estimated glomerular filtration rate (eGFR). We identified the prevalence of risk factors along the eGFR strata and evaluated their influence on the incidence of CIN, defined as a 0.5 mg/dL or 25% increase in serum creatinine after CECT.
RESULTS
Of 432425 CECT examinations in 272136 patients, 140838 examinations in 101487 patients met the eligibility criteria for analysis. The mean age of the participants was 57.9 +/- 15.5 years; 25.1% of the patients were older than 70 years. The prevalence of diabetes mellitus was 11.9%, of hypertension 13.7%, of gout 0.55% and of heart failure was 1.7%. Preventive measures were used in 40238 CECT examinations (28.6%). The prevalence of risk factors and use of preventive measures increased as the renal function became worse. A CIN was occurred after 3103 (2.2%) CECT examinations, revealing a significant association with decreased eGFR, diabetes mellitus, and congestive heart failure after adjustment.
CONCLUSION
Risk factors for CIN are prevalent among the patients undergoing CECT. Preventive measures were seemingly underutilized and a system is needed to improve preventive care.

Keyword

Contrast-induced nephropathy; Contrast-enhanced computed tomography; Prevalence; Risk factor

MeSH Terms

Adult
Aged
Aged, 80 and over
Comorbidity
Contrast Media/*adverse effects
Female
Glomerular Filtration Rate
Humans
Incidence
Kidney Diseases/*chemically induced/epidemiology/*radiography
Male
Middle Aged
Prevalence
Republic of Korea/epidemiology
Risk Factors
Tomography, X-Ray Computed/*methods
Contrast Media

Figure

• 

  Fig. 1 Flow diagram of patient selection. CECT = contrast-enhanced computed tomography, eGFR = estimated glomerular filtration rate

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