Frequency of acute kidney injury following intravenous contrast medium administration: A systematic review and meta-analysis

Jennifer S. McDonald, Robert J. McDonald, Jules Comin, Eric E. Williamson, Richard W Katzberg, M. Hassan Murad, David F. Kallmes

Research output: Contribution to journalReview article

164 Citations (Scopus)

Abstract

Purpose: To perform a systematic review and meta-analysis of controlled studies examining the incidence of acute kidney injury (AKI) and other outcomes in patients exposed to intravenous (IV) contrast medium compared with patients who underwent an imaging examination without contrast medium or were otherwise unexposed (control group). Materials and Methods: MEDLINE, EMBASE, Scopus, and the Cochrane Library were searched for all articles published through September 2011 that contained search terms related to nephrotoxicity following intravenous contrast medium administration. Two independent reviewers identified studies in which the incidence of AKI in patients exposed to IV contrast medium was directly compared with the incidence of AKI in unexposed patients through analysis of changes in serum creatinine level or estimated glomerular filtration rate 48-72 hours following imaging procedures or admission. Study characteristics and outcomes of AKI, dialysis, and mortality were extracted by using a standardized protocol. Relative risk (RR) was calculated by using random-effects models and was tested in subgroups of different patient comorbidities, contrast medium types, and AKI diagnostic criteria. RR results of less than 1.00 indicated that there was a higher incidence of these outcomes in the group that did not receive contrast medium (non-contrast medium group). Results: Of the 1489 studies originally identified, 13 nonrandomized studies (0.9%) representing 25 950 patients met inclusion criteria. In the group that received contrast medium (contrast medium group), risk of AKI (RR = 0.79; 95% confidence interval [CI]: 0.62, 1.02; P = .07), death (RR = 0.95; 95% CI: 0.55, 1.67; P = .87), and dialysis (RR = 0.88; 95% CI: 0.23, 3.43; P = .85) was similar, compared with the risk of AKI in the non-contrast medium group. This pattern was observed regardless of IV contrast medium type, diagnostic criteria for AKI, or whether patients had diabetes mellitus or renal insufficiency. Conclusion: Controlled contrast medium-induced nephropathy studies demonstrate a similar incidence of AKI, dialysis, and death between the contrast medium group and control group.

Original languageEnglish (US)
Pages (from-to)119-128
Number of pages10
JournalRadiology
Volume267
Issue number1
DOIs
StatePublished - Apr 2013

Fingerprint

Acute Kidney Injury
Contrast Media
Meta-Analysis
Dialysis
Incidence
Confidence Intervals
Control Groups
Glomerular Filtration Rate
MEDLINE
Libraries
Renal Insufficiency
Comorbidity
Creatinine
Diabetes Mellitus
Cohort Studies
Outcome Assessment (Health Care)
Mortality

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

McDonald, J. S., McDonald, R. J., Comin, J., Williamson, E. E., Katzberg, R. W., Murad, M. H., & Kallmes, D. F. (2013). Frequency of acute kidney injury following intravenous contrast medium administration: A systematic review and meta-analysis. Radiology, 267(1), 119-128. https://doi.org/10.1148/radiol.12121460

Frequency of acute kidney injury following intravenous contrast medium administration : A systematic review and meta-analysis. / McDonald, Jennifer S.; McDonald, Robert J.; Comin, Jules; Williamson, Eric E.; Katzberg, Richard W; Murad, M. Hassan; Kallmes, David F.

In: Radiology, Vol. 267, No. 1, 04.2013, p. 119-128.

Research output: Contribution to journalReview article

McDonald, JS, McDonald, RJ, Comin, J, Williamson, EE, Katzberg, RW, Murad, MH & Kallmes, DF 2013, 'Frequency of acute kidney injury following intravenous contrast medium administration: A systematic review and meta-analysis', Radiology, vol. 267, no. 1, pp. 119-128. https://doi.org/10.1148/radiol.12121460
McDonald, Jennifer S. ; McDonald, Robert J. ; Comin, Jules ; Williamson, Eric E. ; Katzberg, Richard W ; Murad, M. Hassan ; Kallmes, David F. / Frequency of acute kidney injury following intravenous contrast medium administration : A systematic review and meta-analysis. In: Radiology. 2013 ; Vol. 267, No. 1. pp. 119-128.
@article{6ca52dbd5d1446e294fbfc5c6053842c,
title = "Frequency of acute kidney injury following intravenous contrast medium administration: A systematic review and meta-analysis",
abstract = "Purpose: To perform a systematic review and meta-analysis of controlled studies examining the incidence of acute kidney injury (AKI) and other outcomes in patients exposed to intravenous (IV) contrast medium compared with patients who underwent an imaging examination without contrast medium or were otherwise unexposed (control group). Materials and Methods: MEDLINE, EMBASE, Scopus, and the Cochrane Library were searched for all articles published through September 2011 that contained search terms related to nephrotoxicity following intravenous contrast medium administration. Two independent reviewers identified studies in which the incidence of AKI in patients exposed to IV contrast medium was directly compared with the incidence of AKI in unexposed patients through analysis of changes in serum creatinine level or estimated glomerular filtration rate 48-72 hours following imaging procedures or admission. Study characteristics and outcomes of AKI, dialysis, and mortality were extracted by using a standardized protocol. Relative risk (RR) was calculated by using random-effects models and was tested in subgroups of different patient comorbidities, contrast medium types, and AKI diagnostic criteria. RR results of less than 1.00 indicated that there was a higher incidence of these outcomes in the group that did not receive contrast medium (non-contrast medium group). Results: Of the 1489 studies originally identified, 13 nonrandomized studies (0.9{\%}) representing 25 950 patients met inclusion criteria. In the group that received contrast medium (contrast medium group), risk of AKI (RR = 0.79; 95{\%} confidence interval [CI]: 0.62, 1.02; P = .07), death (RR = 0.95; 95{\%} CI: 0.55, 1.67; P = .87), and dialysis (RR = 0.88; 95{\%} CI: 0.23, 3.43; P = .85) was similar, compared with the risk of AKI in the non-contrast medium group. This pattern was observed regardless of IV contrast medium type, diagnostic criteria for AKI, or whether patients had diabetes mellitus or renal insufficiency. Conclusion: Controlled contrast medium-induced nephropathy studies demonstrate a similar incidence of AKI, dialysis, and death between the contrast medium group and control group.",
author = "McDonald, {Jennifer S.} and McDonald, {Robert J.} and Jules Comin and Williamson, {Eric E.} and Katzberg, {Richard W} and Murad, {M. Hassan} and Kallmes, {David F.}",
year = "2013",
month = "4",
doi = "10.1148/radiol.12121460",
language = "English (US)",
volume = "267",
pages = "119--128",
journal = "Radiology",
issn = "0033-8419",
publisher = "Radiological Society of North America Inc.",
number = "1",

}

TY - JOUR

T1 - Frequency of acute kidney injury following intravenous contrast medium administration

T2 - A systematic review and meta-analysis

AU - McDonald, Jennifer S.

AU - McDonald, Robert J.

AU - Comin, Jules

AU - Williamson, Eric E.

AU - Katzberg, Richard W

AU - Murad, M. Hassan

AU - Kallmes, David F.

PY - 2013/4

Y1 - 2013/4

N2 - Purpose: To perform a systematic review and meta-analysis of controlled studies examining the incidence of acute kidney injury (AKI) and other outcomes in patients exposed to intravenous (IV) contrast medium compared with patients who underwent an imaging examination without contrast medium or were otherwise unexposed (control group). Materials and Methods: MEDLINE, EMBASE, Scopus, and the Cochrane Library were searched for all articles published through September 2011 that contained search terms related to nephrotoxicity following intravenous contrast medium administration. Two independent reviewers identified studies in which the incidence of AKI in patients exposed to IV contrast medium was directly compared with the incidence of AKI in unexposed patients through analysis of changes in serum creatinine level or estimated glomerular filtration rate 48-72 hours following imaging procedures or admission. Study characteristics and outcomes of AKI, dialysis, and mortality were extracted by using a standardized protocol. Relative risk (RR) was calculated by using random-effects models and was tested in subgroups of different patient comorbidities, contrast medium types, and AKI diagnostic criteria. RR results of less than 1.00 indicated that there was a higher incidence of these outcomes in the group that did not receive contrast medium (non-contrast medium group). Results: Of the 1489 studies originally identified, 13 nonrandomized studies (0.9%) representing 25 950 patients met inclusion criteria. In the group that received contrast medium (contrast medium group), risk of AKI (RR = 0.79; 95% confidence interval [CI]: 0.62, 1.02; P = .07), death (RR = 0.95; 95% CI: 0.55, 1.67; P = .87), and dialysis (RR = 0.88; 95% CI: 0.23, 3.43; P = .85) was similar, compared with the risk of AKI in the non-contrast medium group. This pattern was observed regardless of IV contrast medium type, diagnostic criteria for AKI, or whether patients had diabetes mellitus or renal insufficiency. Conclusion: Controlled contrast medium-induced nephropathy studies demonstrate a similar incidence of AKI, dialysis, and death between the contrast medium group and control group.

AB - Purpose: To perform a systematic review and meta-analysis of controlled studies examining the incidence of acute kidney injury (AKI) and other outcomes in patients exposed to intravenous (IV) contrast medium compared with patients who underwent an imaging examination without contrast medium or were otherwise unexposed (control group). Materials and Methods: MEDLINE, EMBASE, Scopus, and the Cochrane Library were searched for all articles published through September 2011 that contained search terms related to nephrotoxicity following intravenous contrast medium administration. Two independent reviewers identified studies in which the incidence of AKI in patients exposed to IV contrast medium was directly compared with the incidence of AKI in unexposed patients through analysis of changes in serum creatinine level or estimated glomerular filtration rate 48-72 hours following imaging procedures or admission. Study characteristics and outcomes of AKI, dialysis, and mortality were extracted by using a standardized protocol. Relative risk (RR) was calculated by using random-effects models and was tested in subgroups of different patient comorbidities, contrast medium types, and AKI diagnostic criteria. RR results of less than 1.00 indicated that there was a higher incidence of these outcomes in the group that did not receive contrast medium (non-contrast medium group). Results: Of the 1489 studies originally identified, 13 nonrandomized studies (0.9%) representing 25 950 patients met inclusion criteria. In the group that received contrast medium (contrast medium group), risk of AKI (RR = 0.79; 95% confidence interval [CI]: 0.62, 1.02; P = .07), death (RR = 0.95; 95% CI: 0.55, 1.67; P = .87), and dialysis (RR = 0.88; 95% CI: 0.23, 3.43; P = .85) was similar, compared with the risk of AKI in the non-contrast medium group. This pattern was observed regardless of IV contrast medium type, diagnostic criteria for AKI, or whether patients had diabetes mellitus or renal insufficiency. Conclusion: Controlled contrast medium-induced nephropathy studies demonstrate a similar incidence of AKI, dialysis, and death between the contrast medium group and control group.

UR - http://www.scopus.com/inward/record.url?scp=84875410288&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84875410288&partnerID=8YFLogxK

U2 - 10.1148/radiol.12121460

DO - 10.1148/radiol.12121460

M3 - Review article

C2 - 23319662

AN - SCOPUS:84875410288

VL - 267

SP - 119

EP - 128

JO - Radiology

JF - Radiology

SN - 0033-8419

IS - 1

ER -