Does intravenous contrast medium administration result in altered renal biomarkers? A study in clinically stable cats with and without azotemia

2021 ◽  
pp. 1098612X2110385
Author(s):  
Maria Laura Prüllage ◽  
Ilse Schwendenwein ◽  
Eva Eberspächer-Schweda ◽  
Sibylle Kneissl
Keyword(s):  
Contrast Media ◽  
Contrast Medium ◽  
Kidney Function ◽  
Kidney Injury ◽  
Intravenous Contrast ◽  
Post Contrast ◽  
Contrast Medium Administration ◽  
Intravenous Contrast Medium ◽  
Blood And Urine Samples ◽  
Contrast Media Administration

Objectives The aim of this study was to determine the prevalence of post-contrast acute kidney injury or comparable side effects on kidney function in cats receiving the non-ionic, iodinated agent ioversol and/or paramagnetic agent gadoteric acid. Methods Fifty-two animals were divided into four groups on the basis of contrast medium administration for imaging: ioversol (n = 27), gadoteric acid (n = 12), dual contrast media (n = 4) or control, which received an infusion of isotone intravenous fluids only during anaesthesia (n = 9). Blood and urine samples were obtained three times after contrast administration and compared with values obtained prior to administration of the contrast medium. Creatinine (<1.60 mg/dl), symmetric dimethylarginine (SDMA; ⩽14 μg/dl), urine protein:creatinine ratio (UPC; <0.2) and critical differences for creatinine (<0.3 mg/dl) and SDMA (<5.98 μg/dl) were measured. Results No significant short-term effects on mean creatinine, SDMA and UPC measurements were seen. Borderline proteinuria (UPC, 0.2–0.4) was detected in 11.4% of cases after contrast media administration. A UPC of more than 0.2 in five cases indicated that contrast media may affect kidney function, leading to (transient) proteinuria. Conclusions and relevance This study found no side effect on renal function following the administration of ioversol or gadoteric acid, provided patients were adequately hydrated. However, the clinical relevance of proteinuria in some cats needs to be evaluated in future studies.

Frequency of Acute Kidney Injury Following Intravenous Contrast Medium Administration: A Systematic Review and Meta-Analysis

Radiology ◽  
2013 ◽  
Vol 267 (1) ◽  
pp. 119-128 ◽  
Author(s):  
Jennifer S. McDonald ◽  
Robert J. McDonald ◽  
Jules Comin ◽  
Eric E. Williamson ◽  
Richard W. Katzberg ◽  
...  
Keyword(s):  
Systematic Review ◽  
Acute Kidney Injury ◽  
Contrast Medium ◽  
Meta Analysis ◽  
Kidney Injury ◽  
Intravenous Contrast ◽  
Contrast Medium Administration ◽  
Intravenous Contrast Medium

MO419THE ROLE OF SHORT-TERM, HIGH-DOSE ATORVASTATIN FOR PREVENTION OF CONTRAST-INDUCED ACUTE KIDNEY INJURY (CI-AKI) IN PATIENTS WITH CARDIOVASCULAR DISEASES UNDERGOING COMPUTED TOMOGRAPHY WITH INTRAVENOUS CONTRAST ADMINISTRATION

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Andrey Vasin ◽  
Olga Mironova ◽  
Viktor Fomin
Keyword(s):  
Computed Tomography ◽  
Acute Kidney Injury ◽  
Cardiovascular Diseases ◽  
Contrast Media ◽  
Kidney Injury ◽  
Ct Scans ◽  
Intravenous Contrast ◽  
Dosing Regimens ◽  
Intravenous Contrast Media ◽  
Contrast Media Administration

Abstract Background and Aims Computed tomography with intravenous contrast media is widely used in hospitals. The incidence of CI-AKI due to intravenous contrast media administration in high-risk patients remains not studied as well as CI-AKI after intraarterial contrast media administration is. According to other researchers, the use of statins in the prevention of AKI after intra-arterial administration of a contrast agent is currently considered an efficient preventive measure. The aim of our study is to assess the incidence of contrast-induced acute kidney injury in patients with cardiovascular diseases during CT scan with intravenous contrast media and analyze the efficacy and safety of various statin dosing regimens for prevention of CI-AKI. Method A randomized controlled open prospective study is planned. Statin naive patients with cardiovascular diseases will be divided into 3 groups. Patients in the first group will receive atorvastatin 80mg 24 hours and 40mg 2 hours before CT scans and 40 mg after. The second group – 40 mg 2 hours before CT scans and 40 mg after. A third group is a control group. Exclusion criteria were current or previous statin treatment, contraindications to statins, severe renal failure, acute coronary syndrome, administration of nephrotoxic drugs. The primary endpoint will the development of CI-AKI, defined as an increase in serum Cr concentration 0.5 mg/dl (44.2 mmol/l) or 25% above baseline at 72 h after exposure to the contrast media. Results We assume a higher incidence of contrast-induced acute kidney injury in the group of patients not receiving statin therapy (about 5-10%). At the same time, it is unlikely to get a significant difference between statin dosing regimens. Risk factors such as age over 75 years, the presence of chronic kidney disease, diabetes mellitus, and chronic heart failure increase the risk of contrast-induced acute kidney injury. Conclusion Despite the significantly lower incidence of CI-AKI with intravenous contrast compared to intra-arterial, patients with CVD have a greater risk of this complication even with intravenous contrast. Therefore, the development of prevention methods and scales for assessing the likelihood of CI-AKI is an important problem. As a result of the study, we expect to conclude the benefits of statins in CI-AKI prevention and the optimal dosage regimen. This information will help us to reduce the burden of CI-AKI after CT scanning in statin naive patients with cardiovascular diseases in everyday clinical practice. ClinicalTrials.gov ID: NCT04666389

Serum neutrophil-gelatinase associated lipocalin as a predictor of post-contrast acute kidney injury in children

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Alyaa A Kotby ◽  
Marwa W Nasef ◽  
Walaa A Kabiel ◽  
Yasser H Mohammad ◽  
Rana M Elmaghrabi
Keyword(s):  
Acute Kidney Injury ◽  
Serum Creatinine ◽  
Contrast Media ◽  
Cardiac Catheterization ◽  
Congenital Heart ◽  
Kidney Injury ◽  
Significant Rise ◽  
Contrast Injection ◽  
Post Contrast ◽  
Contrast Media Administration

Abstract Background Diagnosis of post-contrast acute kidney injury (PC-AKI) by serum creatinine can be delayed because of various factors. A new biomarker neutrophilgelatinase associated lipocalin (NGAL) is postulated to be more sensitive for recognizing patients prone to PC-AKI. Objective To assess serum NGAL changes as an early biomarker of PC-AKI in children with congenital heart disease undergoing cardiac catheterization. Methods This observational study included 30 children with congenital heart disease who underwent cardiac catheterization at the Pediatric Cardiac Catheterization Unit, New Children’s Hospital, Ain Shams University. They had a median age of 30 months and 63% were females. Serum NGAL was measured just before the catheterization, 6hrs and 24hrs after contrast media administration while serum creatinine was measured before and after 24hrs of contrast media administration. Results Significant rise of serum NGAL was noted within 24hrs after contrast administration (p &lt; 0.05) while serum creatinine showed a non-significant rise (p &gt; 0.05). Serum NGAL was positively correlated with age, weight, height, body surface area and rate of contrast injection (p &lt; 0.01). Higher levels of serum NGAL were found among patients who underwent diagnostic cardiac catheterization and those who received Midazolam for initial sedation during induction of anesthesia (p &lt; 0.05). Conclusions Serum NGAL was elevated as early as 6 hours post contrast injection, however its serum level is affected by many factors. It’s important to be aware of other possible risk factors of PC-AKI rather than contrast media as type of cardiac catheterization and the anaesthetic Midazolam.

scholarly journals Coadministration of Liposomal Amphotericin B and Contrast Medium Does Not Increase Risk of Kidney Injury

2017 ◽  
Vol 61 (8) ◽  
Author(s):  
John C. O'Horo ◽  
Douglas R. Osmon ◽  
Omar M. Abu Saleh ◽  
Jasmine R. Marcelin ◽  
Kamel A. Gharaibeh ◽  
...  
Keyword(s):  
Contrast Medium ◽  
Amphotericin B ◽  
Liposomal Amphotericin ◽  
Fungal Infections ◽  
Kidney Injury ◽  
Liposomal Amphotericin B ◽  
Intravenous Contrast ◽  
Intravenous Contrast Medium ◽  
Increased Risk ◽  
Propensity Score Adjustment

ABSTRACT Intravenous radiographic contrast medium and amphotericin B are commonly required in the care of patients with fungal infections. Both interventions have proposed nephrotoxicity through similar mechanisms. We systematically examined patients who received coadministration of liposomal amphotericin B (AmBisome; GE Healthcare) and intravenous contrast medium within a 24-h period and compared the results for those patients with the results for patients who underwent non-contrast medium studies. We found 114 cases and 85 controls during our study period. Overall, no increased risk of renal injury was seen with coadministration of these 2 agents. Adjustment for age, baseline kidney function, and other clinical factors through propensity score adjustment did not change this result. Our observations suggest that, when clinically indicated, coadministration of contrast medium and liposomal amphotericin B does not present excess risk compared with that from the administration of liposomal amphotericin B alone.

Nonconvulsive Status Epilepticus After Intravenous Contrast Medium Administration

Epilepsia ◽  
1996 ◽  
Vol 37 (11) ◽  
pp. 1117-1120 ◽  
Author(s):  
Timothy G. Lukovits ◽  
Camilo E. Fadul ◽  
J. Marc Pipas ◽  
Peter D. Williamson
Keyword(s):  
Status Epilepticus ◽  
Contrast Medium ◽  
Nonconvulsive Status Epilepticus ◽  
Intravenous Contrast ◽  
Contrast Medium Administration ◽  
Intravenous Contrast Medium
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