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Korean J Radiol. 2014 Jul-Aug;15(4):456-63. doi: 10.3348/kjr.2014.15.4.456. Epub 2014 Jul 9.

Contrast-induced nephropathy in patients undergoing intravenous contrast-enhanced computed tomography in Korea: a multi-institutional study in 101487 patients.

Author information

1
Medical Research Collaborating Center, Seoul National University Hospital, Seoul National University College of Medicine, Seoul 110-799, Korea.
2
Department of Radiology, Seoul National University College of Medicine, Seoul 110-744, Korea. ; Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul 110-744, Korea. ; Kidney Research Institute, Seoul National University Medical Research Center, Seoul 110-744, Korea.
3
Department of Radiology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam 463-707, Korea.
4
Department of Radiology, Chonnam National University Hwasun Hospital, Chonnam National University Medical School, Hwasun 519-763, Korea.
5
Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 135-710, Korea.
6
Department of Radiology, Anam Hospital, Korea University College of Medicine, Seoul 136-705, Korea.
7
Department of Radiology, Ewha Womans University Medical Center, Seoul 158-710, Korea.
8
Department of Radiology, Konkuk University Medical Center, Research Institute of Medical Science, Konkuk University School of Medicine, Seoul 143-729, Korea.
9
Department of Radiology, Ajou University School of Medicine, Suwon 443-721, Korea.
10
Department of Diagnostic Radiology, Soonchunhyang University Bucheon Hospital, Bucheon 420-767, Korea.
11
Department of Diagnostic Radiology, Soonchunhyang University Bucheon Hospital, Bucheon 420-767, Korea. ; Department of Radiology, Kyung Hee University Hospital, Seoul 130-702, Korea.
12
Department of Radiology, Chungnam National University School of Medicine, Daejeon 301-721, Korea.
13
Department of Radiology, Yonsei University College of Medicine, Severance Hospital, Seoul 120-752, Korea. ; Department of Radiology, National Cancer Center, Goyang 410-769, Korea.
14
Department of Radiology, Seoul National University Boramae Hospital, Seoul 156-707, Korea.
15
Department of Radiology, Hanyang University College of Medicine, Hanyang University Guri Hospital, Guri 471-701, Korea.
16
Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul 110-746, Korea.
17
Department of Radiology, National Cancer Center, Goyang 410-769, Korea. ; Department of Radiology, Dongguk University Ilsan Hospital, Goyang 410-773, Korea.
18
Department of Radiology, College of Medicine, Dong-A University, Busan 602-714, Korea.
19
Medical Research Collaborating Center, Seoul National University Hospital, Seoul National University College of Medicine, Seoul 110-799, Korea. ; Korea Institute of Drug Safety and Risk Management, Seoul 110-750, Korea. ; Department of Preventive Medicine, Seoul National University College of Medicine, Seoul 110-799, Korea.

Abstract

OBJECTIVE:

To evaluate the prevalence of known risk factors for contrast-induced nephropathy (CIN) and their association with the actual occurrence of CIN in patients undergoing intravenous contrast-enhanced computed tomography (CECT) in Korea.

MATERIALS AND METHODS:

Patients who underwent CECT in 2008 were identified in the electronic medical records of 16 tertiary hospitals of Korea. Data on demographics, comorbidities, prescriptions and laboratory test results of patients were collected following a standard data extraction protocol. The baseline renal function was assessed using the estimated glomerular filtration rate (eGFR). We identified the prevalence of risk factors along the eGFR strata and evaluated their influence on the incidence of CIN, defined as a 0.5 mg/dL or 25% increase in serum creatinine after CECT.

RESULTS:

Of 432425 CECT examinations in 272136 patients, 140838 examinations in 101487 patients met the eligibility criteria for analysis. The mean age of the participants was 57.9 ± 15.5 years; 25.1% of the patients were older than 70 years. The prevalence of diabetes mellitus was 11.9%, of hypertension 13.7%, of gout 0.55% and of heart failure was 1.7%. Preventive measures were used in 40238 CECT examinations (28.6%). The prevalence of risk factors and use of preventive measures increased as the renal function became worse. A CIN was occurred after 3103 (2.2%) CECT examinations, revealing a significant association with decreased eGFR, diabetes mellitus, and congestive heart failure after adjustment.

CONCLUSION:

Risk factors for CIN are prevalent among the patients undergoing CECT. Preventive measures were seemingly underutilized and a system is needed to improve preventive care.

KEYWORDS:

Contrast-enhanced computed tomography; Contrast-induced nephropathy; Prevalence; Risk factor

PMID:
25053905
PMCID:
PMC4105808
DOI:
10.3348/kjr.2014.15.4.456
[Indexed for MEDLINE]
Free PMC Article
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