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Renal Safety of Repeated Intravascular Administrations of Iodinated or Gadolinium-Based Contrast Media within a Short Interval

OBJECTIVE: We aimed to investigate whether repeated intravascular administration of iodinated contrast media (ICM) or gadolinium-based contrast agents (GBCAs) within a short interval was associated with an increased risk of post-contrast acute kidney injury (PC-AKI). MATERIALS AND METHODS: This retr...

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Autores principales: Kwon, Chiheon, Kang, Koung Mi, Choi, Young Hun, Yoo, Roh-Eul, Sohn, Chul-Ho, Han, Seung Seok, Yoon, Soon Ho
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Korean Society of Radiology 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8390825/
https://www.ncbi.nlm.nih.gov/pubmed/34132080
http://dx.doi.org/10.3348/kjr.2020.1153
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author Kwon, Chiheon
Kang, Koung Mi
Choi, Young Hun
Yoo, Roh-Eul
Sohn, Chul-Ho
Han, Seung Seok
Yoon, Soon Ho
author_facet Kwon, Chiheon
Kang, Koung Mi
Choi, Young Hun
Yoo, Roh-Eul
Sohn, Chul-Ho
Han, Seung Seok
Yoon, Soon Ho
author_sort Kwon, Chiheon
collection PubMed
description OBJECTIVE: We aimed to investigate whether repeated intravascular administration of iodinated contrast media (ICM) or gadolinium-based contrast agents (GBCAs) within a short interval was associated with an increased risk of post-contrast acute kidney injury (PC-AKI). MATERIALS AND METHODS: This retrospective study included 300 patients (mean age ± standard deviation, 68.5 ± 8.1 years; 131 male and 169 female) who had undergone at least one ICM-enhanced perfusion brain CT scan, had their baseline and follow-up serum creatinine levels available, and had not undergone additional contrast-enhanced examinations 72 hours before and after a time window of interest were included. The study population was divided into three groups: single-dose group and groups of patients who had received multiple contrast administrations in the time window of interest with the minimum contrast repeat interval either within 4 hours (0–4-hour group) or between 4 to 48 hours (4–48-hour group). Multivariable logistic regression analysis was conducted to evaluate the association between AKI and repeated ICM administrations. A similar supplementary analysis was performed including both ICM and GBCA. RESULTS: When ICM was only considered ignoring GBCA, among 300 patients, 207 patients received a single dose of ICM, 58 had repeated doses within 4 hours (0–4-hour group), and 35 patients had repeated doses between 4 to 48 hours (4–48-hour group). Most patients (> 95%) had a baseline estimated glomerular filtration rate (eGFR) of ≥ 30 mL/min/1.73 m(2). AKI occurred in 7.2%, 13.8%, and 8.6% of patients in the single-dose, 0–4-hour, and 4–48-hour groups, respectively. In the 0–4-hour and 4–48-hour groups, additional exposure to ICM was not associated with AKI after adjusting for comorbidities and nephrotoxic drugs (all p values > 0.05). CONCLUSION: Repeated intravascular administrations of ICM within a short interval did not increase the risk of AKI in our study patients suspected of acute stroke with a baseline eGFR of ≥ 30 mL/min/1.73 m(2).
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spelling pubmed-83908252021-09-04 Renal Safety of Repeated Intravascular Administrations of Iodinated or Gadolinium-Based Contrast Media within a Short Interval Kwon, Chiheon Kang, Koung Mi Choi, Young Hun Yoo, Roh-Eul Sohn, Chul-Ho Han, Seung Seok Yoon, Soon Ho Korean J Radiol Technology, Experiment, and Physics OBJECTIVE: We aimed to investigate whether repeated intravascular administration of iodinated contrast media (ICM) or gadolinium-based contrast agents (GBCAs) within a short interval was associated with an increased risk of post-contrast acute kidney injury (PC-AKI). MATERIALS AND METHODS: This retrospective study included 300 patients (mean age ± standard deviation, 68.5 ± 8.1 years; 131 male and 169 female) who had undergone at least one ICM-enhanced perfusion brain CT scan, had their baseline and follow-up serum creatinine levels available, and had not undergone additional contrast-enhanced examinations 72 hours before and after a time window of interest were included. The study population was divided into three groups: single-dose group and groups of patients who had received multiple contrast administrations in the time window of interest with the minimum contrast repeat interval either within 4 hours (0–4-hour group) or between 4 to 48 hours (4–48-hour group). Multivariable logistic regression analysis was conducted to evaluate the association between AKI and repeated ICM administrations. A similar supplementary analysis was performed including both ICM and GBCA. RESULTS: When ICM was only considered ignoring GBCA, among 300 patients, 207 patients received a single dose of ICM, 58 had repeated doses within 4 hours (0–4-hour group), and 35 patients had repeated doses between 4 to 48 hours (4–48-hour group). Most patients (> 95%) had a baseline estimated glomerular filtration rate (eGFR) of ≥ 30 mL/min/1.73 m(2). AKI occurred in 7.2%, 13.8%, and 8.6% of patients in the single-dose, 0–4-hour, and 4–48-hour groups, respectively. In the 0–4-hour and 4–48-hour groups, additional exposure to ICM was not associated with AKI after adjusting for comorbidities and nephrotoxic drugs (all p values > 0.05). CONCLUSION: Repeated intravascular administrations of ICM within a short interval did not increase the risk of AKI in our study patients suspected of acute stroke with a baseline eGFR of ≥ 30 mL/min/1.73 m(2). The Korean Society of Radiology 2021-09 2021-06-01 /pmc/articles/PMC8390825/ /pubmed/34132080 http://dx.doi.org/10.3348/kjr.2020.1153 Text en Copyright © 2021 The Korean Society of Radiology https://creativecommons.org/licenses/by-nc/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) ) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Technology, Experiment, and Physics
Kwon, Chiheon
Kang, Koung Mi
Choi, Young Hun
Yoo, Roh-Eul
Sohn, Chul-Ho
Han, Seung Seok
Yoon, Soon Ho
Renal Safety of Repeated Intravascular Administrations of Iodinated or Gadolinium-Based Contrast Media within a Short Interval
title Renal Safety of Repeated Intravascular Administrations of Iodinated or Gadolinium-Based Contrast Media within a Short Interval
title_full Renal Safety of Repeated Intravascular Administrations of Iodinated or Gadolinium-Based Contrast Media within a Short Interval
title_fullStr Renal Safety of Repeated Intravascular Administrations of Iodinated or Gadolinium-Based Contrast Media within a Short Interval
title_full_unstemmed Renal Safety of Repeated Intravascular Administrations of Iodinated or Gadolinium-Based Contrast Media within a Short Interval
title_short Renal Safety of Repeated Intravascular Administrations of Iodinated or Gadolinium-Based Contrast Media within a Short Interval
title_sort renal safety of repeated intravascular administrations of iodinated or gadolinium-based contrast media within a short interval
topic Technology, Experiment, and Physics
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8390825/
https://www.ncbi.nlm.nih.gov/pubmed/34132080
http://dx.doi.org/10.3348/kjr.2020.1153
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