当前位置： SCI文献检索 > RADIOLOGY期刊下所有文献 > Intravenous contrast material exposure is not an independent risk factor for dialysis or mortality.

Intravenous contrast material exposure is not an independent risk factor for dialysis or mortality.

Abstract：

PURPOSE:To determine the risk of emergent dialysis and short-term mortality following intravenous iodinated contrast material exposure. MATERIALS AND METHODS:This single-center retrospective study was HIPAA compliant and institutional review board approved. All contrast material-enhanced (contrast group) and unenhanced (noncontrast group) abdominal, pelvic, and thoracic computed tomography scans from 2000-2010 were identified. Patients in the contrast and noncontrast groups were compared following propensity score-based 1:1 matching to reduce intergroup selection bias. Patients with preexisting diabetes mellitus, congestive heart failure, or chronic or acute renal failure were identified as high-risk patient subgroups for nephrotoxicity. The effects of contrast material exposure on the rate of acute kidney injury ( AKI acute kidney injury ) (serum creatinine level ≥ 0.5 mg/dL [44.2 μmol/L] above baseline within 24-72 hours of exposure) and dialysis or death within 30 days of exposure were determined by using odds ratios ( OR odds ratio s) and covariate-adjusted Cox proportional hazards models. Results were validated with a bootstrapped sensitivity analysis. RESULTS:The 1:1 matching on the basis of the propensity score yielded a cohort of 21 346 patients (10 673 in the contrast group, 10 673 in the noncontrast group). Within this cohort, the risks of AKI acute kidney injury ( OR odds ratio , 0.94; 95% confidence interval [ CI confidence interval ]: 0.83, 1.07; P = .38), emergent dialysis ( OR odds ratio , 0.96; 95% CI confidence interval : 0.54, 1.60; P = .89), and 30-day mortality (hazard ratio [ HR hazard ratio ], 0.97; 95% CI confidence interval : 0.87, 1.06; P = .45) were not significantly different between the contrast group and the noncontrast group. Although patients who developed AKI acute kidney injury had higher rates of dialysis and mortality, contrast material exposure was not an independent risk factor for either outcome for dialysis ( OR odds ratio , 0.89; 95% CI confidence interval : 0.40, 2.01; P = .78) or for mortality ( HR hazard ratio , 1.03; 95% CI confidence interval : 0.82, 1.32; P = .63), even among patients with compromised renal function or predisposing comorbidities. CONCLUSION:Intravenous contrast material administration was not associated with excess risk of AKI acute kidney injury , dialysis, or death, even among patients with comorbidities reported to predispose them to nephrotoxicity.

journal_name

Radiology

journal_title

Radiology

authors

McDonald RJ,McDonald JS,Carter RE,Hartman RP,Katzberg RW,Kallmes DF,Williamson EE

doi

10.1148/radiol.14132418

subject

Has Abstract

pub_date

2014-12-01 00:00:00

pages

714-25

issue

eissn

0033-8419

issn

1527-1315

journal_volume

273

pub_type

杂志文章

在线工具

Intravenous contrast material exposure is not an independent risk factor for dialysis or mortality.