Tuberculosis and Respiratory Diseases

The Korean Academy of Tuberculosis and Respiratory Diseases (대한결핵및호흡기학회)
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Incidence and Risk Factors of Contrast-Induced Nephropathy after Bronchial Arteriography or Bronchial Artery Embolization

  • Song, June Seok (Department of Internal Medicine, Hanyang University College of Medicine) ;
  • Kim, Sa Il (Department of Internal Medicine, HanMaEum Medical Center) ;
  • Kim, Woongjun (Department of Internal Medicine, Hanyang University College of Medicine) ;
  • Park, Dong Won (Department of Internal Medicine, Hanyang University College of Medicine) ;
  • Kwak, Hyun Jung (Department of Internal Medicine, Hanyang University College of Medicine) ;
  • Moon, Ji-Yong (Department of Internal Medicine, Hanyang University College of Medicine) ;
  • Kim, Sang-Heon (Department of Internal Medicine, Hanyang University College of Medicine) ;
  • Kim, Tae Hyung (Department of Internal Medicine, Hanyang University College of Medicine) ;
  • Sohn, Jang Won (Department of Internal Medicine, Hanyang University College of Medicine) ;
  • Shin, Dong Ho (Department of Internal Medicine, Hanyang University College of Medicine) ;
  • Park, Sung Soo (Department of Internal Medicine, Hanyang University College of Medicine) ;
  • Yoon, Ho Joo (Department of Internal Medicine, Hanyang University College of Medicine)
  • Received : 2012.10.10
  • Accepted : 2013.04.24
  • Published : 2013.04.30
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Abstract

Background: In uncontrolled hemoptysis patient, bronchial arteriography and bronchial artery embolization (BAE) is a important procedure in diagnosis and treatment. The aim of this study is to assess the incidence of contrast-induced nephropathy and the risk factors of contrast-induced nephropathy (CIN) after bronchial arteriography and BAE. Methods: We retrospectively reviewed the medical records of the patients who underwent bronchial arteriography and BAE in two university hospitals from January 2003 to December 2011. CIN was defined as rise of serum creatinine more than 25% of baseline value or 0.5 mg/dL at between 48 hours and 96 hours after bronchial arteriography and BAE. We excluded patients who already had severe renal insufficiency (serum creatinine${\geq}4.0$) or had been receiving dialysis. Results: Of the total 100 screened patients, 88 patients met the enrollment criteria. CIN developed in 7 patients (8.0%). The mean duration between the exposure and development of CIN was $2.35{\pm}0.81$ days. By using multivariate analysis, serum albumin level was found to be significantly associated with the development of CIN (p=0.0219). Conclusion: These findings suggest that the incidence of CIN was higher than expected and patients with hypoalbuminemia should be monitored more carefully to prevent the development of CIN after bronchial arteriography and BAE.

Keywords

References

  1. Murphy SW, Barrett BJ, Parfrey PS. Contrast nephropathy. J Am Soc Nephrol 2000;11:177-82.
  2. Hou SH, Bushinsky DA, Wish JB, Cohen JJ, Harrington JT. Hospital-acquired renal insufficiency: a prospective study. Am J Med 1983;74:243-8. https://doi.org/10.1016/0002-9343(83)90618-6
  3. Lasser EC, Lyon SG, Berry CC. Reports on contrast media reactions: analysis of data from reports to the U.S. Food and Drug Administration. Radiology 1997;203: 605-10. https://doi.org/10.1148/radiology.203.3.9169676
  4. Fishbane S, Durham JH, Marzo K, Rudnick M. N-acetylcysteine in the prevention of radiocontrast-induced nephropathy. J Am Soc Nephrol 2004;15:251-60. https://doi.org/10.1097/01.ASN.0000107562.68920.92
  5. Gleeson TG, Bulugahapitiya S. Contrast-induced nephropathy. AJR Am J Roentgenol 2004;183:1673-89. https://doi.org/10.2214/ajr.183.6.01831673
  6. Maeder M, Klein M, Fehr T, Rickli H. Contrast nephropathy: review focusing on prevention. J Am Coll Cardiol 2004;44:1763-71. https://doi.org/10.1016/j.jacc.2004.06.075
  7. Goldenberg I, Matetzky S. Nephropathy induced by contrast media: pathogenesis, risk factors and preventive strategies. CMAJ 2005;172:1461-71. https://doi.org/10.1503/cmaj.1040847
  8. Thompson AB, Teschler H, Rennard SI. Pathogenesis, evaluation, and therapy for massive hemoptysis. Clin Chest Med 1992;13:69-82.
  9. Yoon W, Kim JK, Kim YH, Chung TW, Kang HK. Bronchial and nonbronchial systemic artery embolization for life-threatening hemoptysis: a comprehensive review. Radiographics 2002;22:1395-409. https://doi.org/10.1148/rg.226015180
  10. Nash K, Hafeez A, Hou S. Hospital-acquired renal insufficiency. Am J Kidney Dis 2002;39:930-6. https://doi.org/10.1053/ajkd.2002.32766
  11. Barrett BJ. Contrast nephrotoxicity. J Am Soc Nephrol 1994;5:125-37.
  12. Waybill MM, Waybill PN. Contrast media-induced nephrotoxicity: identification of patients at risk and algorithms for prevention. J Vasc Interv Radiol 2001;12: 3-9. https://doi.org/10.1016/S1051-0443(07)61394-3
  13. Nikolsky E, Mehran R, Turcot D, Aymong ED, Mintz GS, Lasic Z, et al. Impact of chronic kidney disease on prognosis of patients with diabetes mellitus treated with percutaneous coronary intervention. Am J Cardiol 2004;94:300-5. https://doi.org/10.1016/j.amjcard.2004.04.023
  14. Russo D, Minutolo R, Cianciaruso B, Memoli B, Conte G, De Nicola L. Early effects of contrast media on renal hemodynamics and tubular function in chronic renal failure. J Am Soc Nephrol 1995;6:1451-8.
  15. Tumlin JA, Wang A, Murray PT, Mathur VS. Fenoldopam mesylate blocks reductions in renal plasma flow after radiocontrast dye infusion: a pilot trial in the prevention of contrast nephropathy. Am Heart J 2002;143: 894-903. https://doi.org/10.1067/mhj.2002.122118
  16. Heinrich MC, Kuhlmann MK, Grgic A, Heckmann M, Kramann B, Uder M. Cytotoxic effects of ionic high-osmolar, nonionic monomeric, and nonionic iso-osmolar dimeric iodinated contrast media on renal tubular cells in vitro. Radiology 2005;235:843-9. https://doi.org/10.1148/radiol.2353040726
  17. Persson PB, Hansell P, Liss P. Pathophysiology of contrast medium-induced nephropathy. Kidney Int 2005; 68:14-22. https://doi.org/10.1111/j.1523-1755.2005.00377.x
  18. Farrugia A. Albumin usage in clinical medicine: tradition or therapeutic? Transfus Med Rev 2010;24:53-63. https://doi.org/10.1016/j.tmrv.2009.09.005
  19. Nicholson JP, Wolmarans MR, Park GR. The role of albumin in critical illness. Br J Anaesth 2000;85:599-610. https://doi.org/10.1093/bja/85.4.599
  20. Choi H, Kim Y, Kim SM, Shin J, Jang HR, Lee JE, et al. Intravenous albumin for the prevention of contrast- induced nephropathy in patients with liver cirrhosis and chronic kidney disease undergoing contrast- enhanced CT. Kidney Res Clin Pract 2012;31:106-11. https://doi.org/10.1016/j.krcp.2012.04.317
  21. Solomon R. Contrast-medium-induced acute renal failure. Kidney Int 1998;53:230-42. https://doi.org/10.1038/sj.ki.4495510

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