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The Incidence and Associated Risk Factors of Contrast-Induced Nephropathy after Contrast-Enhanced Computed Tomography in the Emergency Setting: A Systematic Review
Iodinated contrast media (ICM) during contrast-enhanced computed tomography (CECT) in the emergency department (ED) is essential to diagnose acute conditions, despite risks of contrast-induced nephropathy (CIN) development and its associated complications. This systematic review aims to evaluate the...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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MDPI
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9224719/ https://www.ncbi.nlm.nih.gov/pubmed/35743857 http://dx.doi.org/10.3390/life12060826 |
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author | Ong, Mei-Yi Koh, Justin Jie-Hui Kothan, Suchart Lai, Christopher |
author_facet | Ong, Mei-Yi Koh, Justin Jie-Hui Kothan, Suchart Lai, Christopher |
author_sort | Ong, Mei-Yi |
collection | PubMed |
description | Iodinated contrast media (ICM) during contrast-enhanced computed tomography (CECT) in the emergency department (ED) is essential to diagnose acute conditions, despite risks of contrast-induced nephropathy (CIN) development and its associated complications. This systematic review aims to evaluate the incidence of CIN and CIN-induced complications, and to explore the relevance of classical risk factors for CIN among ED patients receiving ICM. PubMed, Cochrane, and Web of Science were used on 30 August 2021 to search for peer-reviewed English articles reporting on CIN incidence among ED patients aged ≥18 years who underwent an intravenous CECT. The inclusion criteria included studies that were in English, peer-reviewed, and involved ED patients aged ≥18 years who underwent single intravenous CECT. Studies on intra-arterial procedures and preventive strategies, meta-analyses, clinical guidelines, review articles, and case reports were excluded. The JBI critical appraisal checklist was applied to assess the risk of bias. In total, 18 studies were included wherein 15 were retrospective studies while three were prospective studies. We found a relatively higher CIN incidence in the ED, with variations owing to the CIN definitions. Several classical risk factors including acute hypotension remain linked to CIN onset in ED settings unlike factors such as age and diabetes. While risk of adverse renal events due to CIN is low, there is higher risk of CIN-induced mortality in the ED. Therefore, with the higher incidence of CIN and CIN-induced mortality rates in the ED, ICM administration during CECT in the ED should still be clinically justified after assessing both benefits and risks. |
format | Online Article Text |
id | pubmed-9224719 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-92247192022-06-24 The Incidence and Associated Risk Factors of Contrast-Induced Nephropathy after Contrast-Enhanced Computed Tomography in the Emergency Setting: A Systematic Review Ong, Mei-Yi Koh, Justin Jie-Hui Kothan, Suchart Lai, Christopher Life (Basel) Systematic Review Iodinated contrast media (ICM) during contrast-enhanced computed tomography (CECT) in the emergency department (ED) is essential to diagnose acute conditions, despite risks of contrast-induced nephropathy (CIN) development and its associated complications. This systematic review aims to evaluate the incidence of CIN and CIN-induced complications, and to explore the relevance of classical risk factors for CIN among ED patients receiving ICM. PubMed, Cochrane, and Web of Science were used on 30 August 2021 to search for peer-reviewed English articles reporting on CIN incidence among ED patients aged ≥18 years who underwent an intravenous CECT. The inclusion criteria included studies that were in English, peer-reviewed, and involved ED patients aged ≥18 years who underwent single intravenous CECT. Studies on intra-arterial procedures and preventive strategies, meta-analyses, clinical guidelines, review articles, and case reports were excluded. The JBI critical appraisal checklist was applied to assess the risk of bias. In total, 18 studies were included wherein 15 were retrospective studies while three were prospective studies. We found a relatively higher CIN incidence in the ED, with variations owing to the CIN definitions. Several classical risk factors including acute hypotension remain linked to CIN onset in ED settings unlike factors such as age and diabetes. While risk of adverse renal events due to CIN is low, there is higher risk of CIN-induced mortality in the ED. Therefore, with the higher incidence of CIN and CIN-induced mortality rates in the ED, ICM administration during CECT in the ED should still be clinically justified after assessing both benefits and risks. MDPI 2022-06-01 /pmc/articles/PMC9224719/ /pubmed/35743857 http://dx.doi.org/10.3390/life12060826 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Systematic Review Ong, Mei-Yi Koh, Justin Jie-Hui Kothan, Suchart Lai, Christopher The Incidence and Associated Risk Factors of Contrast-Induced Nephropathy after Contrast-Enhanced Computed Tomography in the Emergency Setting: A Systematic Review |
title | The Incidence and Associated Risk Factors of Contrast-Induced Nephropathy after Contrast-Enhanced Computed Tomography in the Emergency Setting: A Systematic Review |
title_full | The Incidence and Associated Risk Factors of Contrast-Induced Nephropathy after Contrast-Enhanced Computed Tomography in the Emergency Setting: A Systematic Review |
title_fullStr | The Incidence and Associated Risk Factors of Contrast-Induced Nephropathy after Contrast-Enhanced Computed Tomography in the Emergency Setting: A Systematic Review |
title_full_unstemmed | The Incidence and Associated Risk Factors of Contrast-Induced Nephropathy after Contrast-Enhanced Computed Tomography in the Emergency Setting: A Systematic Review |
title_short | The Incidence and Associated Risk Factors of Contrast-Induced Nephropathy after Contrast-Enhanced Computed Tomography in the Emergency Setting: A Systematic Review |
title_sort | incidence and associated risk factors of contrast-induced nephropathy after contrast-enhanced computed tomography in the emergency setting: a systematic review |
topic | Systematic Review |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9224719/ https://www.ncbi.nlm.nih.gov/pubmed/35743857 http://dx.doi.org/10.3390/life12060826 |
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