Incidences of acute kidney injury, dialysis, and graft loss following intravenous administration of low-osmolality iodinated contrast in patients with kidney transplants

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Abstract

Purpose: To determine the incidence of acute kidney injury (AKI), need for emergent dialysis, and renal graft loss in patients with kidney transplants, who underwent CT examinations with low-osmolality iodine-based contrast material (IBCM). Materials and methods: Our institutional review board approved this retrospective Health Insurance Portability and Accountability Act compliant study. From January 2005 to April 2015, a total of 224 CT examinations were performed using low-osmolality IBCM in patients with kidney transplants. Six patients who had septic or cardiogenic shock and 30 patients with documented, failed transplants were excluded from our analysis, yielding a total of 188 examinations. Of these, pre- and post-CT serum creatinine (SCr) values were available for 104 examinations, to allow evaluation of AKI. The mean baseline SCr and estimated glomerular filtration rate (eGFR) in this subgroup were 1.37 mg/dL (median 1.18, range 0.5–6.05) and 65.8 mL/min/1.73 m2, respectively (median 65, range 9–114). AKI was defined as a rise in SCr of either (a) ≥0.3 mg/dL or (b) ≥0.5 mg/dL in the 24- to 72-h period following IBCM administration. For all patients undergoing the 188 examinations, need for dialysis and graft loss 30 days after contrast administration were evaluated. Results: In patients with pre- and post-CT SCr values, the incidence of AKI was 7% (7/104) based on a rise of ≥0.3 mg/dL and 3% (3/104) based on a rise of ≥0.5 mg/dL. All three patients with the more strict definition (≥0.5 mg/dL) had a pre-CT eGFR <60 mL/min/1.73 m2. No patient required dialysis or had renal graft loss 30 days after contrast administration. Conclusion: The incidence of AKI after administration of low-osmolality IBCM administration in renal transplant recipients is low, with no instances of emergent dialysis or graft loss at 30 days post contrast.

Original languageEnglish (US)
Pages (from-to)1-5
Number of pages5
JournalAbdominal Radiology
DOIs
StateAccepted/In press - Jul 5 2016

Fingerprint

Acute Kidney Injury
Intravenous Administration
Osmolar Concentration
Dialysis
Transplants
Kidney
Incidence
Iodine
Contrast Media
Creatinine
Serum
Glomerular Filtration Rate
Health Insurance Portability and Accountability Act
Cardiogenic Shock
Research Ethics Committees
Septic Shock
Renal Dialysis

Keywords

  • Contrast
  • Contrast-induced nephropathy
  • CT
  • Kidney
  • Transplant

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Gastroenterology
  • Urology
  • Radiological and Ultrasound Technology

Cite this

@article{c7353eefaf074bc5883a4da487629c97,
title = "Incidences of acute kidney injury, dialysis, and graft loss following intravenous administration of low-osmolality iodinated contrast in patients with kidney transplants",
abstract = "Purpose: To determine the incidence of acute kidney injury (AKI), need for emergent dialysis, and renal graft loss in patients with kidney transplants, who underwent CT examinations with low-osmolality iodine-based contrast material (IBCM). Materials and methods: Our institutional review board approved this retrospective Health Insurance Portability and Accountability Act compliant study. From January 2005 to April 2015, a total of 224 CT examinations were performed using low-osmolality IBCM in patients with kidney transplants. Six patients who had septic or cardiogenic shock and 30 patients with documented, failed transplants were excluded from our analysis, yielding a total of 188 examinations. Of these, pre- and post-CT serum creatinine (SCr) values were available for 104 examinations, to allow evaluation of AKI. The mean baseline SCr and estimated glomerular filtration rate (eGFR) in this subgroup were 1.37 mg/dL (median 1.18, range 0.5–6.05) and 65.8 mL/min/1.73 m2, respectively (median 65, range 9–114). AKI was defined as a rise in SCr of either (a) ≥0.3 mg/dL or (b) ≥0.5 mg/dL in the 24- to 72-h period following IBCM administration. For all patients undergoing the 188 examinations, need for dialysis and graft loss 30 days after contrast administration were evaluated. Results: In patients with pre- and post-CT SCr values, the incidence of AKI was 7{\%} (7/104) based on a rise of ≥0.3 mg/dL and 3{\%} (3/104) based on a rise of ≥0.5 mg/dL. All three patients with the more strict definition (≥0.5 mg/dL) had a pre-CT eGFR <60 mL/min/1.73 m2. No patient required dialysis or had renal graft loss 30 days after contrast administration. Conclusion: The incidence of AKI after administration of low-osmolality IBCM administration in renal transplant recipients is low, with no instances of emergent dialysis or graft loss at 30 days post contrast.",
keywords = "Contrast, Contrast-induced nephropathy, CT, Kidney, Transplant",
author = "Ghaneh Fananapazir and Christoph Troppmann and Corwin, {Michael T} and Nikpour, {Arian M.} and Sima Naderi and Ramit Lamba",
year = "2016",
month = "7",
day = "5",
doi = "10.1007/s00261-016-0827-3",
language = "English (US)",
pages = "1--5",
journal = "Abdominal Radiology",
issn = "2366-004X",
publisher = "Springer New York",

}

TY - JOUR

T1 - Incidences of acute kidney injury, dialysis, and graft loss following intravenous administration of low-osmolality iodinated contrast in patients with kidney transplants

AU - Fananapazir, Ghaneh

AU - Troppmann, Christoph

AU - Corwin, Michael T

AU - Nikpour, Arian M.

AU - Naderi, Sima

AU - Lamba, Ramit

PY - 2016/7/5

Y1 - 2016/7/5

N2 - Purpose: To determine the incidence of acute kidney injury (AKI), need for emergent dialysis, and renal graft loss in patients with kidney transplants, who underwent CT examinations with low-osmolality iodine-based contrast material (IBCM). Materials and methods: Our institutional review board approved this retrospective Health Insurance Portability and Accountability Act compliant study. From January 2005 to April 2015, a total of 224 CT examinations were performed using low-osmolality IBCM in patients with kidney transplants. Six patients who had septic or cardiogenic shock and 30 patients with documented, failed transplants were excluded from our analysis, yielding a total of 188 examinations. Of these, pre- and post-CT serum creatinine (SCr) values were available for 104 examinations, to allow evaluation of AKI. The mean baseline SCr and estimated glomerular filtration rate (eGFR) in this subgroup were 1.37 mg/dL (median 1.18, range 0.5–6.05) and 65.8 mL/min/1.73 m2, respectively (median 65, range 9–114). AKI was defined as a rise in SCr of either (a) ≥0.3 mg/dL or (b) ≥0.5 mg/dL in the 24- to 72-h period following IBCM administration. For all patients undergoing the 188 examinations, need for dialysis and graft loss 30 days after contrast administration were evaluated. Results: In patients with pre- and post-CT SCr values, the incidence of AKI was 7% (7/104) based on a rise of ≥0.3 mg/dL and 3% (3/104) based on a rise of ≥0.5 mg/dL. All three patients with the more strict definition (≥0.5 mg/dL) had a pre-CT eGFR <60 mL/min/1.73 m2. No patient required dialysis or had renal graft loss 30 days after contrast administration. Conclusion: The incidence of AKI after administration of low-osmolality IBCM administration in renal transplant recipients is low, with no instances of emergent dialysis or graft loss at 30 days post contrast.

AB - Purpose: To determine the incidence of acute kidney injury (AKI), need for emergent dialysis, and renal graft loss in patients with kidney transplants, who underwent CT examinations with low-osmolality iodine-based contrast material (IBCM). Materials and methods: Our institutional review board approved this retrospective Health Insurance Portability and Accountability Act compliant study. From January 2005 to April 2015, a total of 224 CT examinations were performed using low-osmolality IBCM in patients with kidney transplants. Six patients who had septic or cardiogenic shock and 30 patients with documented, failed transplants were excluded from our analysis, yielding a total of 188 examinations. Of these, pre- and post-CT serum creatinine (SCr) values were available for 104 examinations, to allow evaluation of AKI. The mean baseline SCr and estimated glomerular filtration rate (eGFR) in this subgroup were 1.37 mg/dL (median 1.18, range 0.5–6.05) and 65.8 mL/min/1.73 m2, respectively (median 65, range 9–114). AKI was defined as a rise in SCr of either (a) ≥0.3 mg/dL or (b) ≥0.5 mg/dL in the 24- to 72-h period following IBCM administration. For all patients undergoing the 188 examinations, need for dialysis and graft loss 30 days after contrast administration were evaluated. Results: In patients with pre- and post-CT SCr values, the incidence of AKI was 7% (7/104) based on a rise of ≥0.3 mg/dL and 3% (3/104) based on a rise of ≥0.5 mg/dL. All three patients with the more strict definition (≥0.5 mg/dL) had a pre-CT eGFR <60 mL/min/1.73 m2. No patient required dialysis or had renal graft loss 30 days after contrast administration. Conclusion: The incidence of AKI after administration of low-osmolality IBCM administration in renal transplant recipients is low, with no instances of emergent dialysis or graft loss at 30 days post contrast.

KW - Contrast

KW - Contrast-induced nephropathy

KW - CT

KW - Kidney

KW - Transplant

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U2 - 10.1007/s00261-016-0827-3

DO - 10.1007/s00261-016-0827-3

M3 - Article

C2 - 27377897

AN - SCOPUS:84976870510

SP - 1

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JO - Abdominal Radiology

JF - Abdominal Radiology

SN - 2366-004X

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