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Frequency of Contrast Nephropathy after Intravenous Contrasted Computerized Tomography Scan in The Patients Admitted to Emergency Department

Year 2019, , 22 - 29, 20.03.2019
https://doi.org/10.31832/smj.512701

Abstract

Frequency of Contrast Nephropathy after Intravenous Contrasted Computerized Tomography Scan in The Patients Admitted to Emergency Department

Objective: In this study, we aimed to determine contrast nephropathy incidence in patients who admitted to emergency department and got intravenous contrasted computerized tomography scan. 
Materials and Methods: Medical records patients who admitted to the emergency department between October 2013 and October 2014 and underwent intravenous contrasted computerized tomography scan were examined. 142 patients over 16 years old were included in our study. Patient data on demographics, clinical and laboratory findings, previous diagnoses, prognoses and prophylactic treatments were collected and examined. 
Results: 50,7 % of the patients were female and 49,3 % were male. The mean age was 52,0. 11,2 % of the patients had contrast nephropathy. When the patients were examined separately at 72th and 120th hours, the incidence of radiocontrast nephropathy was found as 9,2 % and 8,5 %, respectively. Women and patients who had diabetes mellitus, low glomerular filtration rate and malignancy were found to have a high risk for contrast nephropathy.
Conclusion: Intravenous contrast usage has increased in emergency departments. Appropriate risk assessment should be made and prophylactic treatment should be administered to the patients with high risk. Also, serum creatinine values should be examined before intravenous contrast administration and should be monitored closely after the exposure.


References

  • 1. Reddan D. Patients at high risk of adverse events from intravenous contrast media after computed tomography examination. Europen Journal of Radiol 2007;62:26-32.2. Wysowski DK, Nourjah P. Deaths attributed to X-ray contrast media on U.S. death certificates. American Journal of Roentgenology 2006;186:613-5.3. McCullough PA, Adam A, Becker CR, Davidson C, Lameire N, Stacul F, et al. Epidemiology and prognostic implications of contrast-induced nephropathy. The American Journal of Cardiology 2006;98:5-13.4. Jabara R, Gadesam RR, Pendyala LK, Knopf WD, Chronos N, Chen JP, et al. Impact of the definition utilized on the rate of contrast-induced nephropathy in percutaneous coronary intervention. The American Journal of Cardiology 2009;103:1657-62.5. Rihal CS, Textor SC, Grill DE, Berger PB, Ting HH, Best PJ, et al. Incidence and prognostic importance of acute renal failure after percutaneous coronary intervention. Circulation 2002;105:2259-64.6. Konen E, Konen O, Katz M, Levy Y, Rozenman J, Hertz M. Are referring clinicians aware of patients at risk from intravenous injection of iodinated contrast media? Clinical Radiology 2002;57:132-5.7. Mitchell AM, Kline JA. Contrast nephropathy following computed tomography angiography of the chest for pulmonary embolism in the emergency department. Journal of Thrombosis and Haemostasis 2007;5:50-54.8. Hopyan JJ, Gladstone DJ, Mallia G, Schiff J, Fox AJ, Symons SP, et al. Renal safety of CT angiography and perfusion imaging in the emergency evaluation of acute stroke. American Journal of Neuroradiology 2008;29:1826-30.9. Kim KS, Kim K, Hwang SS, Jo YH, Lee CC, Kim TY, et al. Risk stratification nomogram for nephropathy after abdominal contrast-enhanced computed tomography. The American Journalof Emergency Medicine 2011;29:412-7.10. Cavusoglu E, Chhabra S, Marmur JD, Kını A, Sharma SK. The prevention of contrast-induced nephropathy in patients undergoing percutaneous coronary intervention. Minerva Cardioangiol 2004;52:419-32.11. Toprak Ö, Cirit M, Bayata S, Yeşil M. Radyokontrast nefropatisi risk profiliningözden geçirilmesi ve risk değerlendirilmesi. Anadolu Kardiyol Derg 2004;4:331-5.12. Cronin RE. Contrast-induced nephropathy: pathogenesis and prevention. Pediatric Nephrology 2010;25:191-204.13. Marenzi G, Lauri G, Assanelli E, Campodonico J, Metrio MD, Marana I, et al. Contrast-induced nephropathy in patients undergoing primary angioplasty for acute myocardial infarction. Journal of the American College of Cardiology 2004;44:1780-5.14. Pannu N, Wiebe N, Tonelli M. Prophylaxis strategies for contrast-induced nephropathy. JAMA 2006;295:2765-79.15. Mehran R, Aymong ED, Nikolsky E, Lasic Z, Iakovou I, Fahy M, et al. A simple risk score for prediction of contrast-induced nephropathy after percutaneous coronary intervention: development and initial validitation. Journal of the American College of Cardiology 2004;44:1393-9.16. Sadeghi HM, Stone GW, Grines CL, Mehran R, Dixon SR, Lansky AJ, et al. Impact of renal insufficiency in patients undergoing primary angioplasty for acute myocardial infarction. Circulation 2003;108:2769-2775.17. Mueller C, Buerkle G, Perruchoud AP, Buettner HJ. Female sex and risk of contrast nephropathy after percutaneus coronary intervention. The Canadian Journal of Cardiology 2004;20:505-9.18. Ellis JH, Cohan RH. Reducing the risk of contrast-induced nephropathy: a perspective on the controversies. American Journal of Roentgenology 2009;192:1544-9.19. Barrett BJ, Carlisle EJ. Metaanalysis of the relative nephrotoxicity of high and low osmolality iodinated contrast media. Radiology 1993;188:171-8.20. Schrader R. Contrast material-induced renal failure: An overview. Journal of Interventional Cardiology 2005;18:417-23.21. Harris KG, Smith TP, Cragg AH, Lemke JH. Nephrotoxicity from contrast material in renal insufficiency: ionic versus nonionic agents. Radiology 1991;179:849-52.22. Gleeson TG, Bulugahapitiya S. Contrast induced nephropathy. American Journal of Roentgenology 2004;183:1673-89.23. Barrett BJ, Parfrey PS. Preventing nephropathy induced by contrast medium. N Engl J Med 2006;354:379-386.24. Marenzi G, Lauri G, Campodonico J, Marana I, Assanelli E, Metrio MD, et al. Comparison of two hemofiltration protocols for prevention of contrast-induced nephropathy in high-risk patients. The American Journal of Medicine 2006;119:155-62.25. Lin J, Bonventre JV. Prevention of radiocontrast nephropathy. Current Opinion Nephrology Hypertension 2005;14:105-10.26. Stacul F, Adam A, Becker CR, Davidson C, Lameire N, McCullough PA, et al. Strategies to reduce the risk of contrast induced nephropathy. The American Journal of Cardiology 2006;98:59-77.

Acil Servise Başvuran Hastalarda İntravenöz Kontrast Madde Verilerek Çekilen Tomografi Sonrası Kontrast Madde Nefropatisi Gelişme Sıklığı

Year 2019, , 22 - 29, 20.03.2019
https://doi.org/10.31832/smj.512701

Abstract

Acil Servise
Başvuran Hastalarda İntravenöz Kontrast Madde Verilerek Çekilen Tomografi
Sonrası Kontrast Madde Nefropatisi Gelişme Sıklığı

Amaç: Bu
çalışmada erişkin Acil Servisine başvuran ve intravenöz kontrast madde
verilerek bilgisayarlı tomografi çekilen hastalarda kontrast madde nefropatisi
gelişme sıklığının değerlendirilmesi amaçlanmıştır. 
Gereç ve Yöntem: Ekim 2013 - Ekim
2014 tarihleri arasında acil serviste intravenöz kontrast madde verilerek
bilgisayarlı tomografi çekildiği tespit edilen hastaların dosyaları,
retrospektif olarak tarandı. 16 yaş ve üstü 142 hasta çalışmaya alındı. Bu
hastaların demografik, klinik ve laboratuvar verileri, tanıları, klinik
sonlanmaları ve uygulanan profilaktik tedavileri değerlendirildi. 
Bulgular: Hastaların %50,7’sinin
kadın, %49,3’ünün erkek olduğu ve yaş ortalamasının 52,0 olduğu tespit edildi.
Hastaların % 11.2’sinde kontrast madde nefropatisi geliştiği belirlendi. Ayrıca
hastalar 72.saat ve 120.saat olarak iki ayrı zaman diliminde
değerlendirildiğinde kontrast madde nefropati sıklığı % 9.2 ve % 8.5 olarak
tespit edildi. Kadınlarda, diyabeti, malignitesi olanlarda, glomerüler
filtrasyon hızı düşük hastalarda kontrast madde nefropatisi gelişimi açısından
daha yüksek risk saptandı.
Sonuç: Acil servislerde kontrast
madde kullanımı hızla artmaktadır. Hastalara doğru bir risk analizi yapılmalı,
riskli gruplara gerekli profilaktik tedavi uygulanmalı ve kreatinin düzeyi
gerek uygulama öncesi gerekse uygulama sonrası sıkı takip edilmelidir.

References

  • 1. Reddan D. Patients at high risk of adverse events from intravenous contrast media after computed tomography examination. Europen Journal of Radiol 2007;62:26-32.2. Wysowski DK, Nourjah P. Deaths attributed to X-ray contrast media on U.S. death certificates. American Journal of Roentgenology 2006;186:613-5.3. McCullough PA, Adam A, Becker CR, Davidson C, Lameire N, Stacul F, et al. Epidemiology and prognostic implications of contrast-induced nephropathy. The American Journal of Cardiology 2006;98:5-13.4. Jabara R, Gadesam RR, Pendyala LK, Knopf WD, Chronos N, Chen JP, et al. Impact of the definition utilized on the rate of contrast-induced nephropathy in percutaneous coronary intervention. The American Journal of Cardiology 2009;103:1657-62.5. Rihal CS, Textor SC, Grill DE, Berger PB, Ting HH, Best PJ, et al. Incidence and prognostic importance of acute renal failure after percutaneous coronary intervention. Circulation 2002;105:2259-64.6. Konen E, Konen O, Katz M, Levy Y, Rozenman J, Hertz M. Are referring clinicians aware of patients at risk from intravenous injection of iodinated contrast media? Clinical Radiology 2002;57:132-5.7. Mitchell AM, Kline JA. Contrast nephropathy following computed tomography angiography of the chest for pulmonary embolism in the emergency department. Journal of Thrombosis and Haemostasis 2007;5:50-54.8. Hopyan JJ, Gladstone DJ, Mallia G, Schiff J, Fox AJ, Symons SP, et al. Renal safety of CT angiography and perfusion imaging in the emergency evaluation of acute stroke. American Journal of Neuroradiology 2008;29:1826-30.9. Kim KS, Kim K, Hwang SS, Jo YH, Lee CC, Kim TY, et al. Risk stratification nomogram for nephropathy after abdominal contrast-enhanced computed tomography. The American Journalof Emergency Medicine 2011;29:412-7.10. Cavusoglu E, Chhabra S, Marmur JD, Kını A, Sharma SK. The prevention of contrast-induced nephropathy in patients undergoing percutaneous coronary intervention. Minerva Cardioangiol 2004;52:419-32.11. Toprak Ö, Cirit M, Bayata S, Yeşil M. Radyokontrast nefropatisi risk profiliningözden geçirilmesi ve risk değerlendirilmesi. Anadolu Kardiyol Derg 2004;4:331-5.12. Cronin RE. Contrast-induced nephropathy: pathogenesis and prevention. Pediatric Nephrology 2010;25:191-204.13. Marenzi G, Lauri G, Assanelli E, Campodonico J, Metrio MD, Marana I, et al. Contrast-induced nephropathy in patients undergoing primary angioplasty for acute myocardial infarction. Journal of the American College of Cardiology 2004;44:1780-5.14. Pannu N, Wiebe N, Tonelli M. Prophylaxis strategies for contrast-induced nephropathy. JAMA 2006;295:2765-79.15. Mehran R, Aymong ED, Nikolsky E, Lasic Z, Iakovou I, Fahy M, et al. A simple risk score for prediction of contrast-induced nephropathy after percutaneous coronary intervention: development and initial validitation. Journal of the American College of Cardiology 2004;44:1393-9.16. Sadeghi HM, Stone GW, Grines CL, Mehran R, Dixon SR, Lansky AJ, et al. Impact of renal insufficiency in patients undergoing primary angioplasty for acute myocardial infarction. Circulation 2003;108:2769-2775.17. Mueller C, Buerkle G, Perruchoud AP, Buettner HJ. Female sex and risk of contrast nephropathy after percutaneus coronary intervention. The Canadian Journal of Cardiology 2004;20:505-9.18. Ellis JH, Cohan RH. Reducing the risk of contrast-induced nephropathy: a perspective on the controversies. American Journal of Roentgenology 2009;192:1544-9.19. Barrett BJ, Carlisle EJ. Metaanalysis of the relative nephrotoxicity of high and low osmolality iodinated contrast media. Radiology 1993;188:171-8.20. Schrader R. Contrast material-induced renal failure: An overview. Journal of Interventional Cardiology 2005;18:417-23.21. Harris KG, Smith TP, Cragg AH, Lemke JH. Nephrotoxicity from contrast material in renal insufficiency: ionic versus nonionic agents. Radiology 1991;179:849-52.22. Gleeson TG, Bulugahapitiya S. Contrast induced nephropathy. American Journal of Roentgenology 2004;183:1673-89.23. Barrett BJ, Parfrey PS. Preventing nephropathy induced by contrast medium. N Engl J Med 2006;354:379-386.24. Marenzi G, Lauri G, Campodonico J, Marana I, Assanelli E, Metrio MD, et al. Comparison of two hemofiltration protocols for prevention of contrast-induced nephropathy in high-risk patients. The American Journal of Medicine 2006;119:155-62.25. Lin J, Bonventre JV. Prevention of radiocontrast nephropathy. Current Opinion Nephrology Hypertension 2005;14:105-10.26. Stacul F, Adam A, Becker CR, Davidson C, Lameire N, McCullough PA, et al. Strategies to reduce the risk of contrast induced nephropathy. The American Journal of Cardiology 2006;98:59-77.
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Details

Primary Language English
Subjects Health Care Administration
Journal Section Articles
Authors

Hakan Hakkoymaz

Mehmet Okumuş

Publication Date March 20, 2019
Submission Date January 14, 2019
Published in Issue Year 2019

Cite

AMA Hakkoymaz H, Okumuş M. Frequency of Contrast Nephropathy after Intravenous Contrasted Computerized Tomography Scan in The Patients Admitted to Emergency Department. Sakarya Tıp Dergisi. March 2019;9(1):22-29. doi:10.31832/smj.512701

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