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Research Article

Contrast-induced nephropathy in patients undergoing computed tomography (CONNECT) – a clinical problem in daily practice? A multicenter observational study

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Pages 741-750 | Accepted 01 May 2010, Published online: 13 Aug 2010
 

Abstract

Background: Although several studies have examined contrast-induced nephropathy (CIN) following computed tomography (CT) procedures under closely controlled clinical trial conditions, less is known about the incidence of CIN (or its key predictive factors) in a “real world” clinical setting.

Purpose: A multicenter, observational registry study was undertaken in Italian hospital radiology departments to retrospectively assess the incidence of CIN in at-risk patients undergoing iodixanol-enhanced CT procedures.

Material and Methods: Each department used center-specific (nonstandardized) CT protocols. Data were available from 493 at-risk patients; most (76.4%) had 1 risk factor for CIN, 19.8% had 2, and 3.4% had 3. In all, 169 patients (34.3%) had reduced renal function (estimated glomerular filtration rate [eGFR] <60 ml/min/1.73m2). Prophylactic volume expansion was not used in 70.6% of the study population.

Results: The overall incidence of CIN (defined as a ≥44.2 μmol/l [0.5 mg/dl] increase in serum creatinine from baseline 72 h postprocedure) was 2.6%; in the subpopulation of patients with renal impairment (with or without other risk factors), CIN incidence was 4.7%. Multivariate analysis identified renal insufficiency as the only risk factor predictive of CIN (relative risk, 3.850; 95% confidence interval, 1.200–12.348; P=0.023).

Conclusion: In the clinical setting of hospital CT radiology practice, where guideline-recommended strategies for CIN prevention may not be consistently followed, use of the iso-osmolar agent iodixanol appears to be associated with a low incidence of CIN in at-risk patients.

Acknowledgments

The study was funded by GE Healthcare srl, Milan, Italy. Editorial support was provided by A. Brown PhD, of PAREXEL and was funded by GE Healthcare.

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.

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