Korean Journal of Radiology

The Korean Society of Radiology (대한영상의학회)
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Contrast-Induced Nephropathy in Patients Undergoing Intravenous Contrast-Enhanced Computed Tomography in Korea: A Multi-Institutional Study in 101487 Patients

  • Lee, Joongyub (Medical Research Collaborating Center, Seoul National University Hospital, Seoul National University College of Medicine) ;
  • Cho, Jeong Yeon (Department of Radiology, Seoul National University College of Medicine) ;
  • Lee, Hak Jong (Department of Radiology, Seoul National University College of Medicine, Seoul National University Bundang Hospital) ;
  • Jeong, Yong Yeon (Department of Radiology, Chonnam National University Hwasun Hospital, Chonnam National University Medical School) ;
  • Kim, Chan Kyo (Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Park, Byung Kwan (Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Sung, Deuk Jae (Department of Radiology, Anam Hospital, Korea University College of Medicine) ;
  • Kang, Byung Chul (Department of Radiology, Ewha Womans University Medical Center) ;
  • Jung, Sung Il (Department of Radiology, Konkuk University Medical Center, Research Institute of Medical Science, Konkuk University School of Medicine) ;
  • Lee, Eun Ju (Department of Radiology, Ajou University School of Medicine) ;
  • Yi, Boem-Ha (Department of Diagnostic Radiology, Soonchunhyang University Bucheon Hospital) ;
  • Park, Seong Jin (Department of Diagnostic Radiology, Soonchunhyang University Bucheon Hospital) ;
  • Kim, Jong Chul (Department of Radiology, Chungnam National University School of Medicine) ;
  • Jung, Dae Chul (Department of Radiology, Yonsei University College of Medicine, Severance Hospital) ;
  • Sung, Chang-Kyu (Department of Radiology, Seoul National University Boramae Hospital) ;
  • Kim, Yongsoo (Department of Radiology, Hanyang University College of Medicine, Hanyang University Guri Hospital) ;
  • Lee, Youngrae (Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine) ;
  • Kim, Sun Ho (Department of Radiology, National Cancer Center) ;
  • Yoon, Seong Kuk (Department of Radiology, College of Medicine, Dong-A University) ;
  • Park, Byung-Joo (Medical Research Collaborating Center, Seoul National University Hospital, Seoul National University College of Medicine) ;
  • Kim, Seung Hyup (Department of Radiology, Seoul National University College of Medicine) ;
  • Behalf of the Korean Society of Urogenital Radiology (KSUR) and Korean Society of Radiology (Behalf of the Korean Society of Urogenital Radiology (KSUR) and Korean Society of Radiology)
  • Received : 2013.07.05
  • Accepted : 2014.05.08
  • Published : 2014.07.01
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Abstract

Objective: To evaluate the prevalence of known risk factors for contrast-induced nephropathy (CIN) and their association with the actual occurrence of CIN in patients undergoing intravenous contrast-enhanced computed tomography (CECT) in Korea. Materials and Methods: Patients who underwent CECT in 2008 were identified in the electronic medical records of 16 tertiary hospitals of Korea. Data on demographics, comorbidities, prescriptions and laboratory test results of patients were collected following a standard data extraction protocol. The baseline renal function was assessed using the estimated glomerular filtration rate (eGFR). We identified the prevalence of risk factors along the eGFR strata and evaluated their influence on the incidence of CIN, defined as a 0.5 mg/dL or 25% increase in serum creatinine after CECT. Results: Of 432425 CECT examinations in 272136 patients, 140838 examinations in 101487 patients met the eligibility criteria for analysis. The mean age of the participants was $57.9{\pm}15.5years$; 25.1% of the patients were older than 70 years. The prevalence of diabetes mellitus was 11.9%, of hypertension 13.7%, of gout 0.55% and of heart failure was 1.7%. Preventive measures were used in 40238 CECT examinations (28.6%). The prevalence of risk factors and use of preventive measures increased as the renal function became worse. A CIN was occurred after 3103 (2.2%) CECT examinations, revealing a significant association with decreased eGFR, diabetes mellitus, and congestive heart failure after adjustment. Conclusion: Risk factors for CIN are prevalent among the patients undergoing CECT. Preventive measures were seemingly underutilized and a system is needed to improve preventive care.

Keywords

References

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