Risk of renal events following intravenous iodinated contrast material administration among inpatients admitted with cancer a retrospective hospital claims analysis
Abstract Background There is little published evidence examining the use of contrast material (CM) and the risk of acute renal adverse events (AEs) in individuals with increasingly common risk factors including cancer and chronic kidney disease (CKD). The objective of this study was to use real worl...
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| Format: | Article |
| Language: | English |
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BMC
2018-08-01
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| Series: | Cancer Imaging |
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| Online Access: | http://link.springer.com/article/10.1186/s40644-018-0159-3 |
| _version_ | 1818430817916944384 |
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| author | Chaan S. Ng Sanjeeva P. Kalva Candace Gunnarsson Michael P. Ryan Erin R. Baker Ravindra L. Mehta |
| author_facet | Chaan S. Ng Sanjeeva P. Kalva Candace Gunnarsson Michael P. Ryan Erin R. Baker Ravindra L. Mehta |
| author_sort | Chaan S. Ng |
| collection | DOAJ |
| description | Abstract Background There is little published evidence examining the use of contrast material (CM) and the risk of acute renal adverse events (AEs) in individuals with increasingly common risk factors including cancer and chronic kidney disease (CKD). The objective of this study was to use real world hospital data to test the hypothesis that inpatients with cancer having CT procedures with iodinated CM would have higher rates of acute renal AEs in comparison to inpatients without cancer. Methods Inpatient hospital visits in the Premier Hospital Database from January 1, 2010 through September 30, 2015 were eligible for inclusion. The outcome of interest was a composite of acute renal AEs including: acute kidney injury, acute renal failure requiring dialysis, contrast induced-acute kidney injury and renal failure. Multivariable models, adjusted for differences in patient demographics and comorbid conditions, were used to estimate the incremental risk of acute renal AEs by CT (with or without iodinated CM), CKD stage and type of cancer. Results Among 29,850,475 inpatient visits across 611 hospitals, 7.4% had record of a CT scan, 5.9% had CKD, and 3.4% had the primary diagnosis of cancer. The baseline risk for an acute renal AE in patients without cancer or CKD and no CT or CM was 0.5%. The absolute risk increases from baseline by 0.2% with a CT and by 0.8% with iodinated CM. Patients with CKD having a CT scan with iodinated CM have an absolute risk of 4.1 to 9.7% depending on the stage of CKD. For patients with cancer, the absolute risk increases, varying from 0.3 to 2.3% depending on the type of cancer. Conclusions Inpatients with cancer are at higher likelihood of developing acute renal AEs following CT with iodinated CM compared to those without a cancer. Understanding the underlying risks of acute renal AEs among complex inpatient admissions is an important consideration in treatment choices for oncology patients. |
| first_indexed | 2024-12-14T15:39:27Z |
| format | Article |
| id | doaj.art-af89e981346b4f848033dd9f60f39db4 |
| institution | Directory Open Access Journal |
| issn | 1470-7330 |
| language | English |
| last_indexed | 2024-12-14T15:39:27Z |
| publishDate | 2018-08-01 |
| publisher | BMC |
| record_format | Article |
| series | Cancer Imaging |
| spelling | doaj.art-af89e981346b4f848033dd9f60f39db42022-12-21T22:55:39ZengBMCCancer Imaging1470-73302018-08-0118111410.1186/s40644-018-0159-3Risk of renal events following intravenous iodinated contrast material administration among inpatients admitted with cancer a retrospective hospital claims analysisChaan S. Ng0Sanjeeva P. Kalva1Candace Gunnarsson2Michael P. Ryan3Erin R. Baker4Ravindra L. Mehta5MD Anderson Cancer CenterUniversity of Texas Southwestern Medical CenterCTI Clinical Trial & Consulting Services100 ECTI Clinical Trial & Consulting Services100 ECTI Clinical Trial & Consulting Services100 EUniversity of California San Diego 0892 UCSD Medical CenterAbstract Background There is little published evidence examining the use of contrast material (CM) and the risk of acute renal adverse events (AEs) in individuals with increasingly common risk factors including cancer and chronic kidney disease (CKD). The objective of this study was to use real world hospital data to test the hypothesis that inpatients with cancer having CT procedures with iodinated CM would have higher rates of acute renal AEs in comparison to inpatients without cancer. Methods Inpatient hospital visits in the Premier Hospital Database from January 1, 2010 through September 30, 2015 were eligible for inclusion. The outcome of interest was a composite of acute renal AEs including: acute kidney injury, acute renal failure requiring dialysis, contrast induced-acute kidney injury and renal failure. Multivariable models, adjusted for differences in patient demographics and comorbid conditions, were used to estimate the incremental risk of acute renal AEs by CT (with or without iodinated CM), CKD stage and type of cancer. Results Among 29,850,475 inpatient visits across 611 hospitals, 7.4% had record of a CT scan, 5.9% had CKD, and 3.4% had the primary diagnosis of cancer. The baseline risk for an acute renal AE in patients without cancer or CKD and no CT or CM was 0.5%. The absolute risk increases from baseline by 0.2% with a CT and by 0.8% with iodinated CM. Patients with CKD having a CT scan with iodinated CM have an absolute risk of 4.1 to 9.7% depending on the stage of CKD. For patients with cancer, the absolute risk increases, varying from 0.3 to 2.3% depending on the type of cancer. Conclusions Inpatients with cancer are at higher likelihood of developing acute renal AEs following CT with iodinated CM compared to those without a cancer. Understanding the underlying risks of acute renal AEs among complex inpatient admissions is an important consideration in treatment choices for oncology patients.http://link.springer.com/article/10.1186/s40644-018-0159-3Iodinated contrast mediaAcute renal eventCancerContrast-induced nephropathyContrast-induced acute kidney injuryComputed tomography |
| spellingShingle | Chaan S. Ng Sanjeeva P. Kalva Candace Gunnarsson Michael P. Ryan Erin R. Baker Ravindra L. Mehta Risk of renal events following intravenous iodinated contrast material administration among inpatients admitted with cancer a retrospective hospital claims analysis Cancer Imaging Iodinated contrast media Acute renal event Cancer Contrast-induced nephropathy Contrast-induced acute kidney injury Computed tomography |
| title | Risk of renal events following intravenous iodinated contrast material administration among inpatients admitted with cancer a retrospective hospital claims analysis |
| title_full | Risk of renal events following intravenous iodinated contrast material administration among inpatients admitted with cancer a retrospective hospital claims analysis |
| title_fullStr | Risk of renal events following intravenous iodinated contrast material administration among inpatients admitted with cancer a retrospective hospital claims analysis |
| title_full_unstemmed | Risk of renal events following intravenous iodinated contrast material administration among inpatients admitted with cancer a retrospective hospital claims analysis |
| title_short | Risk of renal events following intravenous iodinated contrast material administration among inpatients admitted with cancer a retrospective hospital claims analysis |
| title_sort | risk of renal events following intravenous iodinated contrast material administration among inpatients admitted with cancer a retrospective hospital claims analysis |
| topic | Iodinated contrast media Acute renal event Cancer Contrast-induced nephropathy Contrast-induced acute kidney injury Computed tomography |
| url | http://link.springer.com/article/10.1186/s40644-018-0159-3 |
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