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

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.