Acute renal failure induced by contrast medium: steps towards prevention

Mathew, Robin; Haque, Kmhs Sirajul; Woothipoom, W

doi:10.1136/bmj.38943.401852.80

Cited by 24 publications

(13 citation statements)

References 18 publications

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“…It is especially useful to estimate the GFR in patients with borderline serum Cr, a value of less than 60 mL/min predicts increased risk of contrast nephropathy. 7,27) EVAR is usually possible if patients have appropriate anatomical morphology. Patients who are suitable for EVAR had been thought to have a reduced procedural length, decreased transfusion requirements and require lower amounts of contrast enhanced mediums.…”

Section: Discussionmentioning

confidence: 99%

Clinical Results of Endovascular Abdominal Aortic Aneurysm Repair in Patients with Renal Insufficiency without Hemodialysis

Guntani

Okadome

Kawakubo

et al. 2012

Annals of Vascular Diseases

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Objective: Chronic renal insufficiency may be a relative contraindication to endovascular aneurysm repair (EVAR) for the use of contrast enhanced mediums. It is thought that more contrast enhanced media are needed in patients who are not anatomically suitable for EVAR, because of procedural difficulties. We reviewed a 2 year EVAR experience at our institution to determine whether the procedure and use of contrast enhanced mediums has any deleterious effect on renal function in patients with pre-existing chronic renal insufficiency. Materials and Methods: EVAR was performed in 46 patients with pre-existing chronic renal insufficiency without hemodialysis. Patients were retrospectively assigned to two groups on the basis of their preoperative creatinine clearance levels. Furthermore, patients were assigned to two other groups on the basis of anatomical suitability for EVAR. The absolute change in the serum creatinine (Cr) level was reviewed in the each renal insufficiency group between the preoperative and post-operative time periods. Results: No increase in the serum Cr level was noted, and no patient required temporary or permanent hemodialysis, in any of the groups. Conclusions: EVAR with contrast agents can be accomplished in patients with chronic renal insufficiency without hemodialysis; therefore,elevated Cr levels maynot be a contraindication in EVAR.

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Section: Discussionmentioning

confidence: 99%

Clinical Results of Endovascular Abdominal Aortic Aneurysm Repair in Patients with Renal Insufficiency without Hemodialysis

Guntani

Okadome

Kawakubo

et al. 2012

Annals of Vascular Diseases

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“…Similar results were observed in earlier study. 21 Therefore; patients who are on oral hypoglycaemic and insulin therapy should be included and prioritized in pharmaceutical care services to assess the safety of the treatment and to decrease the prevalence of hospitalizations due to DRPs. Another meta-analysis of Australian studies published from 1988 to 1996 reported that the most commonly implicated drug groups were cytotoxic drugs, cardiovascular agents, anticoagulants and nonsteroidal anti-inflammatory drugs 22 whereas other study reports indicated that anti-thrombotic accounted for the highest incidence (0.24%) of drug related admissions.…”

Section: Adverse Drug Reactionsmentioning

confidence: 99%

Incidence and Factors Associated with Drug Related Hospital Admissions in a South Indian Tertiary Care Hospital

Dammalapati¹,

Challa²,

Challa³

et al. 2018

IJOPP

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Objective:The study aimed to assess the incidence, nature of drug related hospital admissions (DRHAs) and factors associated with DRHAs. Method: A retrospective study was conducted to evaluate the medical records of patients admitted to general medicine department for six months. Drug related hospital admissions were assessed using Helper and Stand Classification. Crude odds ratio (COR) and adjusted odds ratio (AOR) were determined using univariate and multivariate logistic regression analysis. Results: The results of analysis of 1177 medical records reveal that 202 (17.2%) patients were admitted due to 248 DRHAs. Of which, the most common DRHA was non-compliance that accounted for 50.50% (102). Out of 248 drug related hospital admissions, 65.8% (n=163) were definitely preventable, 30.2% (n=75) were possibly preventable and 4.0% (n=10) were definitely not preventable. However, multivariate regression analysis results indicate that hypertension, diabetes mellitus, and polypharmacy at admission are significantly (p< 0.001) associated with DRHA. Conclusion: The factors remarkably associated with drug related hospital admissions are age, diabetes mellitus, hypertension and polypharmacy. The major reasons for drug related hospital admissions are non-compliance and adverse drug reactions. Collaborative efforts among patients, physicians, pharmacists and caregivers might reduce the frequency of drug related hospital admissions.

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“…Contrast-induced nephropathy (CIN) is a common cause of renal failure, and is associated with substantial morbidity and mortality [6][7][8][9] . Multiple studies in the medical literature have estimated a risk of 2% in low-risk patients, rising to 50% in those with risk factors such as diabetes mellitus (DM), pre-existing renal disease, congestive heart failure, advanced age, anemia, and dehydration [10][11][12][13][14][15] . Although cirrhosis has been suggested as a risk factor for CIN [13][14][15][16][17] , only two studies, to our knowledge, have specifically investigated this issue.…”

Section: Introductionmentioning

confidence: 99%

Risk of contrast-induced nephropathy in hospitalized patients with cirrhosis

Lodhia¹,

Kader²,

Mayes³

et al. 2009

WJG

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AIM:To evaluate the incidence of contrast-induced nephropathy (CIN) in cirrhotic patients and to identify risk factors for the development of CIN. METHODS:We performed a retrospective review of 216 consecutive patients with cirrhosis who underwent computed tomography (CT) with intravenous contrast at the University of Rochester between the years 2000-2005. We retrospectively examined factors associated with a high risk for CIN, defined as a decrease in creatinine clearance of 25% or greater within one week after receiving contrast. RESULTS:Twenty-five percent of our patients developed CIN, and 74% of these patients had ascites seen on CT. Of the 75% of patients who did not develop CIN, only 46% had ascites. The presence of ascites was a significant risk factor for the development of CIN (P = 0.0009, OR 3.38, 95% CI 1.55-7.34) in multivariate analysis. Patient age, serum sodium, Model for End-stage Liver Disease score, diuretic use, and the presence of diabetes were not found to be significant risk factors for the development of CIN. Of the patients who developed CIN, 11% developed chronic renal insufficiency, defined as a creatinine clearance less than baseline for 6 wk. CONCLUSION:Our results suggest that in hospitalized cirrhotic patients, especially those with ascites, the risk of CIN is substantial.

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Acute renal failure induced by contrast medium: steps towards prevention

Cited by 24 publications

References 18 publications

Clinical Results of Endovascular Abdominal Aortic Aneurysm Repair in Patients with Renal Insufficiency without Hemodialysis

Clinical Results of Endovascular Abdominal Aortic Aneurysm Repair in Patients with Renal Insufficiency without Hemodialysis

Incidence and Factors Associated with Drug Related Hospital Admissions in a South Indian Tertiary Care Hospital

Risk of contrast-induced nephropathy in hospitalized patients with cirrhosis

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