scholarly journals Intravenous iodinated contrast is not associated with acute kidney injury in adult patients with nephrotic syndrome

2019 ◽  
Vol 5 (2) ◽  
Author(s):  
Andrew Bacyinski
Keyword(s):  
Acute Kidney Injury ◽  
Nephrotic Syndrome ◽  
Retrospective Cohort ◽  
Critical Appraisal ◽  
Kidney Injury ◽  
European Radiology ◽  
Iodinated Contrast ◽  
Contrast Enhanced Ct ◽  
Contrast Enhanced ◽  
Enhanced Ct

<p>A critical appraisal and clinical application of Tao SM, Kong X, Schoepf UJ, et al. Acute kidney injury in patients with nephrotic syndrome undergoing contrast-enhanced CT for suspected venous thromboembolism: a propensity score-matched retrospective cohort study. <em>European Radiology</em>. 2018;28(4):1585-1593. doi: <a href="https://doi.org/10.1007/s00330-017-5109-0">10.1007/s00330-017-5109-0</a></p>

scholarly journals Contrast-Induced Acute Kidney Injury: Definition, Epidemiology, and Outcome

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Felix G. Meinel ◽  
Carlo N. De Cecco ◽  
U. Joseph Schoepf ◽  
Richard Katzberg
Keyword(s):  
Acute Kidney Injury ◽  
Renal Function ◽  
Renal Insufficiency ◽  
Time Window ◽  
Contrast Material ◽  
Kidney Injury ◽  
Preventive Strategy ◽  
Iodinated Contrast ◽  
Contrast Enhanced Ct ◽  
Contrast Enhanced

Contrast-induced acute kidney injury (CI-AKI) is commonly defined as a decline in kidney function occurring in a narrow time window after administration of iodinated contrast material. The incidence of AKI after contrast material administration greatly depends on the specific definition and cutoff values used. Although self-limiting in most cases, postcontrast AKI carries a risk of more permanent renal insufficiency, dialysis, and death. The risk of AKI from contrast material, in particular when administered intravenously for contrast-enhanced CT, has been exaggerated by older, noncontrolled studies due to background fluctuations in renal function. More recent evidence from controlled studies suggests that the risk is likely nonexistent in patients with normal renal function, but there may be a risk in patients with renal insufficiency. However, even in this patient population, the risk of CI-AKI is probably much smaller than traditionally assumed. Since volume expansion is the only preventive strategy with a convincing evidence base, liberal hydration should be encouraged to further minimize the risk. The benefits of the diagnostic information gained from contrast-enhanced examinations will still need to be balanced with the potential risk of CI-AKI for the individual patient and clinical scenario.

scholarly journals Post-Contrast Acute Kidney Injury in Patients with Various Stages of Chronic Kidney Disease—Is Fear Justified?

Toxins ◽  
2021 ◽  
Vol 13 (6) ◽  
pp. 395
Author(s):  
Inga Chomicka ◽  
Marlena Kwiatkowska ◽  
Alicja Lesniak ◽  
Jolanta Malyszko
Keyword(s):  
Computed Tomography ◽  
Chronic Kidney Disease ◽  
Acute Kidney Injury ◽  
Kidney Disease ◽  
Kidney Injury ◽  
Creatinine Concentration ◽  
Post Contrast ◽  
Iodinated Contrast ◽  
Contrast Enhanced Ct ◽  
Enhanced Ct

Post-contrast acute kidney injury (PC-AKI) is one of the side effects of iodinated contrast media, including those used in computed tomography. Its incidence seems exaggerated, and thus we decided to try estimate that number and investigate its significance in our clinical practice. We analyzed all computed tomographies performed in our clinic in 2019, including data about the patient and the procedure. In each case, we recorded the parameters of kidney function (serum creatinine concentration and eGFR) in four time intervals: before the test, immediately after the test, 14–28 days after the test, and over 28 days after the test. Patients who did not have a follow-up after computed tomography were excluded. After reviewing 706 CT scans performed in 2019, we included 284 patients undergoing contrast-enhanced CT and 67 non-enhanced CT in the final analysis. On this basis, we created two comparable groups in terms of age, gender, the severity of chronic kidney disease, and the number of comorbidities. We found that AKI was more common in the non-enhanced CT population (25.4% vs. 17.9%). In terms of our experience, it seems that PC-AKI is not a great risk for patients, even those with chronic kidney disease. Consequently, the fear of using contrast agents is not justified.

scholarly journals Is the Presence of a Solitary Kidney an Independent Risk Factor for Acute Kidney Injury after Contrast-enhanced CT?

Radiology ◽  
2016 ◽  
Vol 278 (1) ◽  
pp. 74-81 ◽  
Author(s):  
Jennifer S. McDonald ◽  
Richard W. Katzberg ◽  
Robert J. McDonald ◽  
Eric E. Williamson ◽  
David F. Kallmes
Keyword(s):  
Acute Kidney Injury ◽  
Risk Factor ◽  
Independent Risk Factor ◽  
Kidney Injury ◽  
Solitary Kidney ◽  
Contrast Enhanced Ct ◽  
Contrast Enhanced ◽  
Enhanced Ct

scholarly journals Risk of Acute Kidney Injury Following Contrast-enhanced CT in Hospitalized Pediatric Patients: A Propensity Score Analysis

Radiology ◽  
2020 ◽  
Vol 294 (3) ◽  
pp. 548-556 ◽  
Author(s):  
Leah A. Gilligan ◽  
Matthew S. Davenport ◽  
Andrew T. Trout ◽  
Weizhe Su ◽  
Bin Zhang ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Propensity Score ◽  
Pediatric Patients ◽  
Propensity Score Analysis ◽  
Kidney Injury ◽  
Contrast Enhanced Ct ◽  
Score Analysis ◽  
Contrast Enhanced ◽  
Enhanced Ct

scholarly journals Giant bladder stone resulting in acute kidney injury; a case report and review of literature

2022 ◽  
Author(s):  
Feysel Hassen Issack ◽  
Kaleab Habtemichael Gebresellasie ◽  
Fitsum Gebreegziabher Gebrehiwot ◽  
Mubarek Bargicho Adem ◽  
Ferid Ousman Mummed ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Wound Care ◽  
Kidney Injury ◽  
Bladder Stone ◽  
Contrast Enhanced Ct ◽  
Contrast Enhanced ◽  
Enhanced Ct ◽  
Urinary Tract Symptoms ◽  
Lower Urinary

Abstract A giant bladder stone is very rare in adults. We report a case of giant bladder stone causing acute kidney injury in a 23-year-old male, who presented with lower urinary tract symptoms (LUTS) characterized by both irritative and obstructive LUTS. In addition, he also had episodes of reddish urine for the past decade. A non-contrast-enhanced CT scan was used for the diagnosis. Open cystolithotomy was performed and a 500g weighing stone was removed. He developed a superficial surgical site infection which was treated with wound care. He was discharged improved. Improvement in symptoms and serum creatinine was noted on follow-up.

Abstract 504: Cystatin-C Risk-Stratifies Patients for Acute Kidney Injury and 1-Year Major Vascular Events Following Contrast -Enhanced CT Imaging in the Emergency Care Setting

2015 ◽  
Vol 35 (suppl_1) ◽  
Author(s):  
Alice M Mitchell ◽  
Jeffrey A Kline ◽  
Roxanne Y Williams ◽  
David P Basile ◽  
Shawn D Teague ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Cystatin C ◽  
Emergency Care ◽  
Care Setting ◽  
Kidney Injury ◽  
Ct Imaging ◽  
Vascular Events ◽  
Contrast Enhanced Ct ◽  
Contrast Enhanced ◽  
Enhanced Ct

Background: Despite poor sensitivity in acutely ill patients, serum creatinine (and estimated glomerular filtration rate [eGFR SCR ]) remains the sole means of risk-stratifying patients for acute kidney injury (AKI) prior to contrast-enhanced CT imaging (CECT). Hypothesis: We hypothesized that an acute phase marker of renal dysfunction, cystatin-C (expressed as eGFR CYS ), would more accurately predict contrast-induced nephropathy (CIN) than eGFR SCR . Given the risk of arterial vascular events subsequent to AKI, we also evaluated eGFR CYS in risk-stratifying patients for major adverse events (MAE) within 1 year of CECT. Methods: We followed 462 consecutive adults, without end-stage renal disease, undergoing CECT (any indication) in the outpatient, emergency care setting for CIN and 1-year MAE: death, renal failure, myocardial infarction, stroke, and/or peripheral vascular event requiring intervention (blinded, adjudicated outcome). We excluded patients with life-threatening CECT indications and collected serum for eGFR SCR and eGFR CYS prior to CECT. Predictive accuracy was defined as the area under the receiver operating characteristic curve (AUROC) and likelihood ratios (LR+ and LR-). A threshold of ≤60 ml/min/m 2 defined an abnormal eGFR SCR or eGFR CYS . Results: CIN occurred in 14% and a MAE in 17% (low observer variability, κ>0.9) of our heterogeneous population: mean age 50 yrs (±16 yrs), 51% discharged after CECT, 16% with diabetes mellitus (DM), and only 16% with eGFR SCR ≤60ml/min/m 2 . CIN was associated with 1-year MAE: RR 2.4 (1.5-4.0) after adjusting for age and existing co-morbidities (active malignancy, CHF, DM, and CAD). The AUROC, LR+ and LR- for eGFR SCR were 0.55 (0.47-0.63), 0.9 (0.4-2.1) and 1.0 (0.9-1.1). In comparison, the AUROC, LR+, and LR- for eGFR CYS were 0.79 (0.62-0.96), 5.5 (3.9-7.6) and 0.43 (0.31-0.57), respectively. The MAE rate did not differ in patients with normal (13%) or abnormal (15%, p=0.5) pre-CECT eGFR SCR . Whereas, an abnormal eGFR SCR was associated with a 29% (p<0.01) increase in MAE. Conclusions: In patients undergoing CECT in the outpatient setting, eGFR CYS more accurately predicted CIN and more effectively risk-stratified patients for 1-year MAE than eGFR SCR . These findings warrant prospective validation.

scholarly journals Giant bladder stone resulting in acute kidney injury; a case report and review of literature

2022 ◽  
Author(s):  
Fitsum Gebreegziabher Gebrehiwot ◽  
Mubarek Bargicho Adem ◽  
Feysel Hassen Issack ◽  
Kaleab Habtemichael Gebresellasie ◽  
Ferid Ousman Mummed ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Wound Care ◽  
Kidney Injury ◽  
Bladder Stone ◽  
Contrast Enhanced Ct ◽  
Contrast Enhanced ◽  
Enhanced Ct ◽  
Urinary Tract Symptoms ◽  
Lower Urinary

Abstract A giant bladder stone is very rare in adults. We report a case of giant bladder stone causing acute kidney injury in a 23-year-old male, who presented with lower urinary tract symptoms (LUTS) characterized by both irritative and obstructive LUTS. In addition, he also had episodes of reddish urine for the past decade. A non-contrast-enhanced CT scan was used for the diagnosis. Open cystolithotomy was performed and a 500g weighing stone was removed. He developed a superficial surgical site infection which was treated with wound care. He was discharged improved. Improvement in symptoms and serum creatinine was noted on follow-up.

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