Patients with Different Stages of Chronic Kidney Disease Undergoing Intravenous Contrast-Enhanced Computed Tomography—The Incidence of Contrast-Associated Acute Kidney Injury
Introduction: Iodinated contrast medium (CM) is the third most common cause of acute kidney injury (AKI). However, the association is poorly known between the definitions of AKI between different stages of chronic kidney disease after intravenous CM administration. Methods: The dataset, covering a p...
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-03-01
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| Series: | Diagnostics |
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| Online Access: | https://www.mdpi.com/2075-4418/12/4/864 |
| _version_ | 1797436080321986560 |
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| author | Ming-Ju Wu Shang-Feng Tsai |
| author_facet | Ming-Ju Wu Shang-Feng Tsai |
| author_sort | Ming-Ju Wu |
| collection | DOAJ |
| description | Introduction: Iodinated contrast medium (CM) is the third most common cause of acute kidney injury (AKI). However, the association is poorly known between the definitions of AKI between different stages of chronic kidney disease after intravenous CM administration. Methods: The dataset, covering a period of ~15 years (1 June 2008 to 31 March 2015), consisted of 20,018 non-dialytic adult patients who had received intravenous injections of non-ionic iso-osmolar CM, iodixanol, for enhanced computed tomography imaging. Contrast-associated AKI (CA-AKI), dialysis-required AKI, and mortality were analyzed. Results: A total of 12,271 participants were enrolled. CA-AKI increased significantly starting from stage 3A onward (<i>p</i> < 0.001). In summary, incidences of CA-AKI against different levels of chronic kidney disease were as follows: stage 1 (8.3%) = stage 2 (6.7%) < stage 3A (9.9%) < stage 3B (14.3%) < stage 4 (20.5%) = stage 5 (20.4%). The incidences of dialysis within 30 days were as follows: stage 1 (1%) = stage 2 (1.4%) = stage 3A (2.7%) < stage 3B (5.7%) < stage 4 (18%) < stage 5 (54.1%). The prediction of dialysis was good based on the baseline serum creatinine > 1.5 mg/dL (72.78% of sensitivity, 86.07% of specificity, 0.851 of area under curve) or baseline estimated glomerular filtration rate ≤ 38.49 mL/min/1.732 m<sup>2</sup> (70.19% of sensitivity, 89.08% of specificity, 0.853 of area under curve). In multivariate Cox regression analysis model for CA-AKI, independent risk factors were stage 4 chronic kidney disease (<i>p</i> = 0.001) and shock (<i>p</i> = 0.001). Conclusion: Baseline serum creatinine and estimated glomerular filtration rate were good predictors for dialysis-required AKI. CA-AKI increased significantly since stage 3A chronic kidney disease. Stage 4 and 5 chronic kidney disease have the same risk for CA-AKI, but stage 5 chronic kidney disease has markedly higher risk for dialysis. |
| first_indexed | 2024-03-09T10:57:31Z |
| format | Article |
| id | doaj.art-b00618ead46548ef89659f8ea4a170e0 |
| institution | Directory Open Access Journal |
| issn | 2075-4418 |
| language | English |
| last_indexed | 2024-03-09T10:57:31Z |
| publishDate | 2022-03-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Diagnostics |
| spelling | doaj.art-b00618ead46548ef89659f8ea4a170e02023-12-01T01:31:58ZengMDPI AGDiagnostics2075-44182022-03-0112486410.3390/diagnostics12040864Patients with Different Stages of Chronic Kidney Disease Undergoing Intravenous Contrast-Enhanced Computed Tomography—The Incidence of Contrast-Associated Acute Kidney InjuryMing-Ju Wu0Shang-Feng Tsai1Division of Nephrology, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung 407, TaiwanDivision of Nephrology, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung 407, TaiwanIntroduction: Iodinated contrast medium (CM) is the third most common cause of acute kidney injury (AKI). However, the association is poorly known between the definitions of AKI between different stages of chronic kidney disease after intravenous CM administration. Methods: The dataset, covering a period of ~15 years (1 June 2008 to 31 March 2015), consisted of 20,018 non-dialytic adult patients who had received intravenous injections of non-ionic iso-osmolar CM, iodixanol, for enhanced computed tomography imaging. Contrast-associated AKI (CA-AKI), dialysis-required AKI, and mortality were analyzed. Results: A total of 12,271 participants were enrolled. CA-AKI increased significantly starting from stage 3A onward (<i>p</i> < 0.001). In summary, incidences of CA-AKI against different levels of chronic kidney disease were as follows: stage 1 (8.3%) = stage 2 (6.7%) < stage 3A (9.9%) < stage 3B (14.3%) < stage 4 (20.5%) = stage 5 (20.4%). The incidences of dialysis within 30 days were as follows: stage 1 (1%) = stage 2 (1.4%) = stage 3A (2.7%) < stage 3B (5.7%) < stage 4 (18%) < stage 5 (54.1%). The prediction of dialysis was good based on the baseline serum creatinine > 1.5 mg/dL (72.78% of sensitivity, 86.07% of specificity, 0.851 of area under curve) or baseline estimated glomerular filtration rate ≤ 38.49 mL/min/1.732 m<sup>2</sup> (70.19% of sensitivity, 89.08% of specificity, 0.853 of area under curve). In multivariate Cox regression analysis model for CA-AKI, independent risk factors were stage 4 chronic kidney disease (<i>p</i> = 0.001) and shock (<i>p</i> = 0.001). Conclusion: Baseline serum creatinine and estimated glomerular filtration rate were good predictors for dialysis-required AKI. CA-AKI increased significantly since stage 3A chronic kidney disease. Stage 4 and 5 chronic kidney disease have the same risk for CA-AKI, but stage 5 chronic kidney disease has markedly higher risk for dialysis.https://www.mdpi.com/2075-4418/12/4/864acute kidney injurydialysismortalitychronic kidney diseaseintravenous contrast mediumcomputed tomography |
| spellingShingle | Ming-Ju Wu Shang-Feng Tsai Patients with Different Stages of Chronic Kidney Disease Undergoing Intravenous Contrast-Enhanced Computed Tomography—The Incidence of Contrast-Associated Acute Kidney Injury Diagnostics acute kidney injury dialysis mortality chronic kidney disease intravenous contrast medium computed tomography |
| title | Patients with Different Stages of Chronic Kidney Disease Undergoing Intravenous Contrast-Enhanced Computed Tomography—The Incidence of Contrast-Associated Acute Kidney Injury |
| title_full | Patients with Different Stages of Chronic Kidney Disease Undergoing Intravenous Contrast-Enhanced Computed Tomography—The Incidence of Contrast-Associated Acute Kidney Injury |
| title_fullStr | Patients with Different Stages of Chronic Kidney Disease Undergoing Intravenous Contrast-Enhanced Computed Tomography—The Incidence of Contrast-Associated Acute Kidney Injury |
| title_full_unstemmed | Patients with Different Stages of Chronic Kidney Disease Undergoing Intravenous Contrast-Enhanced Computed Tomography—The Incidence of Contrast-Associated Acute Kidney Injury |
| title_short | Patients with Different Stages of Chronic Kidney Disease Undergoing Intravenous Contrast-Enhanced Computed Tomography—The Incidence of Contrast-Associated Acute Kidney Injury |
| title_sort | patients with different stages of chronic kidney disease undergoing intravenous contrast enhanced computed tomography the incidence of contrast associated acute kidney injury |
| topic | acute kidney injury dialysis mortality chronic kidney disease intravenous contrast medium computed tomography |
| url | https://www.mdpi.com/2075-4418/12/4/864 |
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