Skip to main content

Main menu

  • Home
  • Content
    • Published Ahead of Print
    • Current Issue
    • Subject Collections
    • Archives
    • Saved Searches
  • Authors
    • Submit a Manuscript
    • Author Resources
    • Reprint Information
  • Trainees
    • Peer Review Program
    • Prize Competition
  • Editorial Team
  • Subscriptions
  • More
    • Advertising
    • Reprint Information
    • Impact Factor
    • About CJASN
    • Feedback
  • Other
    • JASN
    • Kidney360
    • Kidney News Online
    • In the Loop
    • American Society of Nephrology

User menu

  • Subscribe
  • My alerts
  • Log in
  • My Cart

Search

  • Advanced search
American Society of Nephrology
  • Other
    • JASN
    • Kidney360
    • Kidney News Online
    • In the Loop
    • American Society of Nephrology
  • Subscribe
  • My alerts
  • Log in
  • My Cart
Advertisement
American Society of Nephrology

Advanced Search

  • Home
  • Content
    • Published Ahead of Print
    • Current Issue
    • Subject Collections
    • Archives
    • Saved Searches
  • Authors
    • Submit a Manuscript
    • Author Resources
    • Reprint Information
  • Trainees
    • Peer Review Program
    • Prize Competition
  • Editorial Team
  • Subscriptions
  • More
    • Advertising
    • Reprint Information
    • Impact Factor
    • About CJASN
    • Feedback
  • Visit ASN on Facebook
  • Follow CJASN on Twitter
  • CJASN RSS
  • Community Forum
Acute Renal Failure
You have accessRestricted Access

Incidence and Outcomes of Contrast-Induced AKI Following Computed Tomography

Steven D. Weisbord, Maria K. Mor, Abby L. Resnick, Kathryn C. Hartwig, Paul M. Palevsky and Michael J. Fine
CJASN September 2008, 3 (5) 1274-1281; DOI: https://doi.org/10.2215/CJN.01260308
Steven D. Weisbord
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Maria K. Mor
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Abby L. Resnick
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Kathryn C. Hartwig
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Paul M. Palevsky
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Michael J. Fine
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • Article
  • Figures & Data
  • Info & Metrics
  • PDF
Loading

Article Figures & Data

Figures

  • Tables
  • Figure 1.
    • Download figure
    • Open in new tab
    • Download powerpoint
    Figure 1.

    Patient selection.

Tables

  • Figures
    • View popup
    Table 1.

    Patient demographic and clinical characteristics

    DemographicsOverall (n = 421)Inpatient (n = 127)Outpatient (n = 294)P
        age (yr)69 ± 1070 ± 1069 ± 100.5
        male403 (96)121 (95)282 (96)0.8
        white385 (91)114 (90)271 (92)0.5
        black31 (7)11 (9)20 (7)0.5
    Comorbid illnesses
        diabetes mellitus172 (41)60 (47)112 (38)0.09
        liver disease59 (14)20 (16)39 (13)0.5
        congestive heart failure68 (16)30 (24)38 (13)0.01
        peripheral vascular disease54 (13)19 (15)35 (12)0.4
        cerebrovascular disease45 (11)23 (18)22 (7)<0.01
    Baseline renal function
        serum creatinine (mg/dl)1.4 (1.3, 1.5)1.4 (1.3, 1.5)1.4 (1.3, 1.5)1.0
        eGFR (ml/min per 1.73 m2)53 (48, 57)52 (49, 56)53 (48, 57)0.7
        eGFR 30–59 ml/min per 1.73 m2421 (100)127 (100)294 (100)1.0
        eGFR 15–29 ml/min per 1.73 m20 (0)0 (0)0 (0)NC
        eGFR <15 ml/min per 1.73 m20 (0)0 (0)0 (0)NC
    Preexisting medication use
        nonsteroidal anti-inflammatories40 (10)11 (9)29 (10)0.9
        loop diuretics101 (24)36 (28)65 (22)0.2
        angiotensin converting enzyme inhibitors161 (38)42 (33)119 (40)0.2
        theophylline2 (0.5)1 (1.0)1 (0.3)0.5
    • eGFR, estimated glomerular filtration rate; NC, not calculable. Data are n (%), mean ± SD, or median (interquartile range).

    • View popup
    Table 2.

    Use of preventive care

    Overall (n = 421)Inpatient (n = 127)Outpatient (n = 294)P
    Intravenous fluid use
    Preprocedure84 (20)62 (49)22 (7)<0.01
    Postprocedure91 (22)70 (55)21 (7)<0.01
    Preprocedure and postprocedure70 (17)53 (42)17 (6)<0.01
    N-acetylcysteine use73 (17)48 (38)25 (9)<0.01
    Discontinuation of non-steroidal anti-inflammatoriesa0 (0)0 (0)(0) 0—
    Instructed to increase oral fluids74 (18)33 (26)41 (14)<0.01
    Complied with increase in oral fluidsb59 (80)28 (82)31 (76)0.4
    • Data are n (%).

    • ↵a n (%) of the 40 study patients taking nonsteroidal anti-inflammatories.

    • ↵b n (%) of patients who were instructed to increase oral fluids.

    • View popup
    Table 3.

    Incidence of contrast-induced acute kidney injury

    CIAKI definitionOverall (n = 367)Inpatient (n = 119)Outpatient (n = 248)Pb
    All patients
        ≥ 25%24 (6.5)15 (12.6)9 (3.6)0.001
        ≥ 50%a2 (0.5)1 (0.8)1 (0.4)0.6
        ≥ 100%(0) 00 (0)0 (0)—
        ≥ 0.25 mg/dl40 (10.9)21 (17.6)19 (7.7)0.004
        ≥ 0.5 mg/dl13 (3.5)8 (6.7)5 (2.0)0.2
        ≥ 1.0 mg/dl1 (0.3)0 (0)1 (0.4)0.5
    eGFR ≤ 45 ml/min per 1.73 m2n = 51n = 15n = 36
        ≥ 25%6 (11.8)2 (13.3)4 (11.1)0.8
        ≥ 50%a1 (2.0)0 (0)1 (2.8)0.5
        ≥ 100%0 (0)0 (0)0 (0)—
        ≥ 0.25 mg/dl7 (13.7)2 (13.3)5 (13.9)0.9
        ≥ 0.5 mg/dl5 (9.8)2 (13.3)3 (8.3)0.6
        ≥ 1.0 mg/dl1 (2.0)0 (0)1 (2.8)0.5
    eGFR > 45 ml/min per 1.73 m2n = 316n = 104n = 212
        ≥ 25%18 (5.7)13 (12.5)5 (2.4)<0.001
        ≥ 50%a1 (0.3)1 (1)0 (0)0.2
        ≥ 100%0 (0)0 (0)0 (0)—
        ≥ 0.25 mg/dl33 (10.4)19 (18.3)14 (6.6)0.001
        ≥ 0.5 mg/dl8 (2.5)6 (5.7)2 (0.9)0.01
        ≥ 1.0 mg/dl0 (0)0 (0)0 (0)—
    • eGFR, estimated glomerular filtration rate; —, not applicable. Data are n (%).

    • ↵a The 2 patients meeting this definition of CIAKI also met criteria for RISK category of acute kidney injury as defined by RIFLE criteria.

    • ↵b Comparison of CIAKI between inpatients and outpatients.

    • View popup
    Table 4.

    Associations of patient and procedural factors with the development of CIAKI

    Patient factorOdds of CIAKI (↑ Scr ≥ 25%)Odds of CIAKI (↑ Scr ≥0.5 mg/dl)
    Age >65 yr1.0 (0.4, 2.4)1.1 (0.3, 3.7)
    Diabetes mellitus1.4 (0.6, 3.1)1.2 (0.4, 3.5)
    Congestive heart failure2.4 (1.0, 5.9)4.1 (1.3, 12.7)
    Peripheral vascular disease2.4 (0.9, 6.4)2.1 (0.5, 7.8)
    Cerebrovascular disease1.3 (0.4, 4.4)0.7 (0.1, 5.6)
    Scr > 1.5 mg/dl2.5 (1.1, 5.9)5.7 (1.8, 17.8)
    eGFR ≤ 45 ml/min per 1.73 m22.1 (0.8, 5.6)4.0 (1.3, 12.7)
    Hematocrit < 35%1.8 (0.8, 4.3)2.6 (0.8, 7.9)
    Inpatient status3.8 (1.6, 9.0)3.5 (1.1, 10.9)
    Procedure factors
    Contrast (iso-osmolal)0.5 (0.2, 1.3)0.9 (0.2, 4.4)
    Dose contrast > 100 ml3.3 (1.0, 11.5)2.5 (0.6, 11.7)
    Preprocedure and postprocedure IV fluid1.6 (0.6, 4.1)0.8 (0.2, 3.8)
    N-acetylcysteine use2.4 (1.9, 5.8)2.0 (0.6, 6.7)
    • Data presented as odds ratios and 95% confidence limits.

    • View popup
    Table 5.

    Association of contrast-induced acute kidney injury with mortality

    Definition of CIAKI based on Δ ScrUnadjusted OR for deatha95% CIAdjusted OR for deathb95% CI
    ≥ 25%3.80.4–20.62.20.2–14.6
    ≥ 50%NC———
    ≥ 100%NC———
    ≥ 0.25 mg/dl2.10.2–11.01.70.1–10.9
    ≥ 0.5 mg/dl7.70.7–45.94.80.4–39.5
    ≥ 1.0 mg/dlNC———
    • OR, odds ratio; CI, confidence interval; NC, not calculable (because of absence of deaths); —, not applicable.

    • ↵a ORs are based on comparisons of patients who did and did not develop CIAKI.

    • ↵b Adjusted for status at time of procedure and cerebrovascular disease.

PreviousNext
Back to top

In this issue

Clinical Journal of the American Society of Nephrology
Vol. 3, Issue 5
September 2008
  • Table of Contents
  • Table of Contents (PDF)
  • Index by author
View Selected Citations (0)
Print
Download PDF
Article Alerts
Sign In to Email Alerts with your Email Address
Email Article
Thank you for your help in sharing the high-quality science in CJASN.
Enter multiple addresses on separate lines or separate them with commas.
Incidence and Outcomes of Contrast-Induced AKI Following Computed Tomography
(Your Name) has sent you a message from American Society of Nephrology
(Your Name) thought you would like to see the American Society of Nephrology web site.
Citation Tools
Incidence and Outcomes of Contrast-Induced AKI Following Computed Tomography
Steven D. Weisbord, Maria K. Mor, Abby L. Resnick, Kathryn C. Hartwig, Paul M. Palevsky, Michael J. Fine
CJASN Sep 2008, 3 (5) 1274-1281; DOI: 10.2215/CJN.01260308

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero
Request Permissions
Share
Incidence and Outcomes of Contrast-Induced AKI Following Computed Tomography
Steven D. Weisbord, Maria K. Mor, Abby L. Resnick, Kathryn C. Hartwig, Paul M. Palevsky, Michael J. Fine
CJASN Sep 2008, 3 (5) 1274-1281; DOI: 10.2215/CJN.01260308
del.icio.us logo Digg logo Reddit logo Twitter logo CiteULike logo Facebook logo Google logo Mendeley logo
  • Tweet Widget
  • Facebook Like

Jump to section

  • Article
    • Abstract
    • Materials and Methods
    • Results
    • Discussion
    • Conclusions
    • Disclosures
    • Acknowledgments
    • Footnotes
    • References
  • Figures & Data
  • Info & Metrics
  • PDF

More in this TOC Section

  • Urinary Biomarkers and Renal Recovery in Critically Ill Patients with Renal Support
  • An Assessment of the Acute Kidney Injury Network Creatinine-Based Criteria in Patients Submitted to Mechanical Ventilation
  • Circulating miR-210 Predicts Survival in Critically Ill Patients with Acute Kidney Injury
Show more Acute Renal Failure

Cited By...

  • Gastrointestinal ultrasound in inflammatory bowel disease: an underused resource with potential paradigm-changing application
  • Cardiometabolic Risk Is Associated With Atherosclerotic Burden and Prognosis: Results From the Partners Coronary Computed Tomography Angiography Registry
  • Contrast-Induced Nephropathy in Critical Care
  • Renal Dysfunction as an Independent Predictor of Outcome After Aneurysmal Subarachnoid Hemorrhage: A Single-Center Cohort Study
  • Contrast-Induced Acute Kidney Injury: Is There a Risk after Intravenous Contrast?
  • Scopus (149)
  • Google Scholar

Similar Articles

Related Articles

  • Contrast-Induced Acute Kidney Injury: Is There a Risk after Intravenous Contrast?
  • Scopus
  • PubMed
  • Google Scholar

About

  • ASN
  • CJASN
  • ASN Journals
  • ASN Podcasts
  • CJASN Relaunch

Author Information

  • Submit a Manuscript
  • Trainee of the Year
  • Author Resources
  • Reuse/Reprint Policy

More information

  • Advertise
  • Subscribe
  • Email Alerts
  • Sections by Topic
  • Password/Email Address Changes

© 2019 American Society of Nephrology

Print ISSN - 1555-9041 Online ISSN - 1555-905X

Powered by HighWire