The Controversy of Contrast-Induced Nephropathy With Intravenous Contrast: What Is the Risk?

Rudnick, Michael R.; Leonberg‐Yoo, Amanda K.; Litt, Harold; Cohen, Raphael M.; Hilton, Susan; Reese, Peter P.

doi:10.1053/j.ajkd.2019.05.022

Cited by 121 publications

(117 citation statements)

References 88 publications

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“…This is the frist sutdy to point out the incidence of PC-AKI regarding hyperbilirubinemia. The incidence of PC-AKI varied from 12 to 50% according to different baseline conditions [2][3][4][44][45][46]. The incidence of PC-AKI in patients with total bilirubin> 2.0 mg/dl maybe relatively low because of the following reasons.…”

Section: Plos Onementioning

confidence: 99%

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Severe hyperbilirubinemia is associated with higher risk of contrast-related acute kidney injury following contrast-enhanced computed tomography

Cheng

et al. 2020

PLoS ONE

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Introduction Contrast-induced acute kidney injury (CI-AKI) is associated with high risks of morbidity and mortality. Hyperbilirubinemia might have some renal protection but with no clear cutoff value for protection. Related studies are typically on limited numbers of patients and only in conditions of vascular intervention. Methods We performed this study to elucidate CI-AKI in patients after contrast-enhanced computed tomography (CCT). The outcomes were CI-AKI, dialysis and mortality. Patients were divided to three groups based on their serum levels of total bilirubin: �1.2 mg/dl, 1.3-2.0 mg/dl, and >2.0 mg/dl. Results We enrolled a total of 9,496 patients who had received CCT. Patients with serum total bilirubin >2.0 mg/dl were associated with CI-AKI. Those undergoing dialysis had the highest incidence of PC-AKI (p<0.001). No difference was found between the two groups of total bilirubin �1.2 and 1.3-2.0 mg/dl. Patients with total bilirubin >2mg/dl were associated with CI-AKI (OR = 1.89, 1.53-2.33 of 95% CI), dialysis (OR = 1.40, 1.01-1.95 of 95% CI) and mortality (OR = 1.63, 1.38-1.93 of 95% CI) after adjusting for laboratory data and all comorbidities (i.e., cerebrovascular disease, coronary artery disease, peripheral arterial disease, and acute myocardial infarction, diabetes mellitus, hypertension, gastrointestinal bleeding, cirrhosis, peritonitis, ascites, hepatoma, shock lung and colon cancer). We concluded that total bilirubin level >2 mg/dl is an independent risk factor for CI-AKI, dialysis and mortality after CCT. These patients also had high risks for cirrhosis or hepatoma.

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Section: Plos Onementioning

confidence: 99%

“…Formerly called contrast-induced nephropathy, it has now been called contrast-induced AKI (CI-AKI). The incidence of CI-AKI is high, with 12 to 50% morbidity [1][2][3][4]. Despite of its nephrotoxicity, the iodine-containing contrast medium is required to obtain good quality images.…”

Section: Introductionmentioning

confidence: 99%

Severe hyperbilirubinemia is associated with higher risk of contrast-related acute kidney injury following contrast-enhanced computed tomography

Cheng

et al. 2020

PLoS ONE

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“…The consensus statement published by the American College of Radiology (ACR) and National Kidney Foundation posits that the risk of acute kidney injury (AKI) has previously been overstated, due to historical lack of control groups to separate contrastinduced AKI and contrast-associated AKI. 54,55 While the true risk of contrast-induced AKI is unknown, prophylactic normal saline administration is recommended for glomerular filtration rate (GFR) less than 30 mL/min/1.73 m 2 . A randomized trial has shown no benefit of sodium bicarbonate or N-acetylcysteine when compared with normal saline.…”

Section: Computed Tomographymentioning

confidence: 99%

Surveillance Imaging following Endovascular Aneurysm Repair: State of the Art

Kim

Litt

2020

Semin intervent Radiol

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Endovascular aneurysmal repair (EVAR) has become a prominent modality for the treatment of abdominal aortic aneurysm. Surveillance imaging is important for the detection of device-related complications, which include endoleak, structural abnormalities, and infection. Currently used modalities include ultrasound, X-ray, computed tomography, magnetic resonance imaging, and angiography. Understanding the advantages and drawbacks of each modality, as well available guidelines, can guide selection of the appropriate technique for individual patients. We review complications following EVAR and advances in surveillance imaging modalities.

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“…Numerous studies showed the value of endothelin, which has been detected to increase after contrast media exposure (24). The attentions are also toward the role of adenosine in inducing contrast-associated acute kidney injury, while intra-renal injected adenosine makes hemodynamic disturbances similar to contrast nephropathy (25,26).…”

Section: Pathophysiology Of Contrast-associated Acute Kidney Injurymentioning

confidence: 99%

Prevention of contrast-associated acute kidney injury in cancer patients undergoing radiologic investigation using contrast media; a short-review to current knowledge

Dayani

Mirzazadeh

2019

J Nephropathol

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Contrast agents are non-biologically active substances required for various diagnostic imaging procedures. Exposure to contrast materials, predispose some patients to renal disturbances entitled as contrast-associated acute kidney injury. Nephropathy of contrast medium is a deterioration of renal function which happens within 24 to 72 hours after iodinated contrast medium injection. Cancer individuals have several risk factors for contrast-associated acute renal failure, consisting of administration of chemotherapy regimen, which are mainly nephrotoxic, presence of diabetes or chronic renal failure, hypertension, taking of non-steroidal anti-inflammatory drugs, simultaneous use of nephrotoxic drugs, aminoglycosides, cisplatin, cyclosporine A or amphotericin B, increases the risk of contrast-associated acute renal failure. Similarly, age more than65 years old and anemia is an independent risk factor for contrast-associated acute kidney injury and also timing of CT within 45 days after last chemotherapy and low fluid intake, as the common risk factors in cancer individuals.

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The Controversy of Contrast-Induced Nephropathy With Intravenous Contrast: What Is the Risk?

Cited by 121 publications

References 88 publications

Severe hyperbilirubinemia is associated with higher risk of contrast-related acute kidney injury following contrast-enhanced computed tomography

Severe hyperbilirubinemia is associated with higher risk of contrast-related acute kidney injury following contrast-enhanced computed tomography

Surveillance Imaging following Endovascular Aneurysm Repair: State of the Art

Prevention of contrast-associated acute kidney injury in cancer patients undergoing radiologic investigation using contrast media; a short-review to current knowledge

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