Risk of contrast-induced nephropathy for patients receiving intravenous vs. intra-arterial iodixanol administration

Gregory E. Tong, Sant Kumar, Karen C. Chong, Nikita Shah, Margaret J. Wong, Jeffrey M. Zimmet, Zhen Jane Wang, Judy Yee, Yanjun Fu, Benjamin M. Yeh

Research output: Contribution to journalArticle

14 Citations (Scopus)

Abstract

Purpose: To compare the incidence of contrast-induced nephropathy (CIN) for intravenous vs. intra-arterial administration of iodixanol, compared to non-administration. Methods: We retrospectively identified 650 patients who had intravenous iodixanol-enhanced CT, 695 with intra-arterial iodixanol cardiac catheterization, 651 with unenhanced CT, and those who also had baseline and follow-up serum creatinine within 5 days of the exam. From the medical records, we recorded the gender, age, baseline and follow-up serum creatinine/eGFR; underlying renal injury risk factors; indication for imaging; contrast material administration volume, concentration, and route of administration; and use of pre-imaging prophylactic measures for CIN. Univariate and multivariate models were used to determine predictors of CIN. Results: Baseline eGFR was lower for patients undergoing unenhanced CT than intravenous or intra-arterial patients (68 vs. 74.6 and 72.2, respectively, p < 0.01) and not different between intravenous and intra-arterial patients (p = 0.735). Simple logistic regression did not show a difference in the rate of CIN in patients who received intravenous vs. intra-arterial iodixanol (28 of 650, 4%, vs. 28 of 695, 4%, respectively, p = 0.798), nor a higher rate of CIN than seen with unenhanced CT (45 of 651, 7%, p = 0.99 and p = 0.98 by one-sided t test). Multivariate regression modeling showed that only elevated baseline creatinine or decreased eGFR and low hematocrit/hemoglobin were associated with CIN incidence (odds ratio 1.28 and 2.5; p < 0.023 and <0.006, respectively). Conclusions: Elevation in serum creatinine due to intravenous and intra-arterial iodixanol administration is infrequent and is not more common than after unenhanced CT scans.

Original languageEnglish (US)
Pages (from-to)91-99
Number of pages9
JournalAbdominal Radiology
Volume41
Issue number1
DOIs
StatePublished - Jan 1 2016
Externally publishedYes

Fingerprint

Creatinine
Serum
Incidence
Cardiac Catheterization
Hematocrit
Contrast Media
Medical Records
Hemoglobins
Logistic Models
Odds Ratio
iodixanol
Kidney
Wounds and Injuries

Keywords

  • Cardiac catheterization
  • Contrast-induced nephropathy
  • CT
  • Intra-arterial
  • Intravenous
  • Renal

ASJC Scopus subject areas

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

Cite this

Tong, G. E., Kumar, S., Chong, K. C., Shah, N., Wong, M. J., Zimmet, J. M., ... Yeh, B. M. (2016). Risk of contrast-induced nephropathy for patients receiving intravenous vs. intra-arterial iodixanol administration. Abdominal Radiology, 41(1), 91-99. https://doi.org/10.1007/s00261-015-0611-9

Risk of contrast-induced nephropathy for patients receiving intravenous vs. intra-arterial iodixanol administration. / Tong, Gregory E.; Kumar, Sant; Chong, Karen C.; Shah, Nikita; Wong, Margaret J.; Zimmet, Jeffrey M.; Wang, Zhen Jane; Yee, Judy; Fu, Yanjun; Yeh, Benjamin M.

In: Abdominal Radiology, Vol. 41, No. 1, 01.01.2016, p. 91-99.

Research output: Contribution to journalArticle

Tong, GE, Kumar, S, Chong, KC, Shah, N, Wong, MJ, Zimmet, JM, Wang, ZJ, Yee, J, Fu, Y & Yeh, BM 2016, 'Risk of contrast-induced nephropathy for patients receiving intravenous vs. intra-arterial iodixanol administration', Abdominal Radiology, vol. 41, no. 1, pp. 91-99. https://doi.org/10.1007/s00261-015-0611-9
Tong, Gregory E. ; Kumar, Sant ; Chong, Karen C. ; Shah, Nikita ; Wong, Margaret J. ; Zimmet, Jeffrey M. ; Wang, Zhen Jane ; Yee, Judy ; Fu, Yanjun ; Yeh, Benjamin M. / Risk of contrast-induced nephropathy for patients receiving intravenous vs. intra-arterial iodixanol administration. In: Abdominal Radiology. 2016 ; Vol. 41, No. 1. pp. 91-99.
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abstract = "Purpose: To compare the incidence of contrast-induced nephropathy (CIN) for intravenous vs. intra-arterial administration of iodixanol, compared to non-administration. Methods: We retrospectively identified 650 patients who had intravenous iodixanol-enhanced CT, 695 with intra-arterial iodixanol cardiac catheterization, 651 with unenhanced CT, and those who also had baseline and follow-up serum creatinine within 5 days of the exam. From the medical records, we recorded the gender, age, baseline and follow-up serum creatinine/eGFR; underlying renal injury risk factors; indication for imaging; contrast material administration volume, concentration, and route of administration; and use of pre-imaging prophylactic measures for CIN. Univariate and multivariate models were used to determine predictors of CIN. Results: Baseline eGFR was lower for patients undergoing unenhanced CT than intravenous or intra-arterial patients (68 vs. 74.6 and 72.2, respectively, p < 0.01) and not different between intravenous and intra-arterial patients (p = 0.735). Simple logistic regression did not show a difference in the rate of CIN in patients who received intravenous vs. intra-arterial iodixanol (28 of 650, 4{\%}, vs. 28 of 695, 4{\%}, respectively, p = 0.798), nor a higher rate of CIN than seen with unenhanced CT (45 of 651, 7{\%}, p = 0.99 and p = 0.98 by one-sided t test). Multivariate regression modeling showed that only elevated baseline creatinine or decreased eGFR and low hematocrit/hemoglobin were associated with CIN incidence (odds ratio 1.28 and 2.5; p < 0.023 and <0.006, respectively). Conclusions: Elevation in serum creatinine due to intravenous and intra-arterial iodixanol administration is infrequent and is not more common than after unenhanced CT scans.",
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AU - Shah, Nikita

AU - Wong, Margaret J.

AU - Zimmet, Jeffrey M.

AU - Wang, Zhen Jane

AU - Yee, Judy

AU - Fu, Yanjun

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N2 - Purpose: To compare the incidence of contrast-induced nephropathy (CIN) for intravenous vs. intra-arterial administration of iodixanol, compared to non-administration. Methods: We retrospectively identified 650 patients who had intravenous iodixanol-enhanced CT, 695 with intra-arterial iodixanol cardiac catheterization, 651 with unenhanced CT, and those who also had baseline and follow-up serum creatinine within 5 days of the exam. From the medical records, we recorded the gender, age, baseline and follow-up serum creatinine/eGFR; underlying renal injury risk factors; indication for imaging; contrast material administration volume, concentration, and route of administration; and use of pre-imaging prophylactic measures for CIN. Univariate and multivariate models were used to determine predictors of CIN. Results: Baseline eGFR was lower for patients undergoing unenhanced CT than intravenous or intra-arterial patients (68 vs. 74.6 and 72.2, respectively, p < 0.01) and not different between intravenous and intra-arterial patients (p = 0.735). Simple logistic regression did not show a difference in the rate of CIN in patients who received intravenous vs. intra-arterial iodixanol (28 of 650, 4%, vs. 28 of 695, 4%, respectively, p = 0.798), nor a higher rate of CIN than seen with unenhanced CT (45 of 651, 7%, p = 0.99 and p = 0.98 by one-sided t test). Multivariate regression modeling showed that only elevated baseline creatinine or decreased eGFR and low hematocrit/hemoglobin were associated with CIN incidence (odds ratio 1.28 and 2.5; p < 0.023 and <0.006, respectively). Conclusions: Elevation in serum creatinine due to intravenous and intra-arterial iodixanol administration is infrequent and is not more common than after unenhanced CT scans.

AB - Purpose: To compare the incidence of contrast-induced nephropathy (CIN) for intravenous vs. intra-arterial administration of iodixanol, compared to non-administration. Methods: We retrospectively identified 650 patients who had intravenous iodixanol-enhanced CT, 695 with intra-arterial iodixanol cardiac catheterization, 651 with unenhanced CT, and those who also had baseline and follow-up serum creatinine within 5 days of the exam. From the medical records, we recorded the gender, age, baseline and follow-up serum creatinine/eGFR; underlying renal injury risk factors; indication for imaging; contrast material administration volume, concentration, and route of administration; and use of pre-imaging prophylactic measures for CIN. Univariate and multivariate models were used to determine predictors of CIN. Results: Baseline eGFR was lower for patients undergoing unenhanced CT than intravenous or intra-arterial patients (68 vs. 74.6 and 72.2, respectively, p < 0.01) and not different between intravenous and intra-arterial patients (p = 0.735). Simple logistic regression did not show a difference in the rate of CIN in patients who received intravenous vs. intra-arterial iodixanol (28 of 650, 4%, vs. 28 of 695, 4%, respectively, p = 0.798), nor a higher rate of CIN than seen with unenhanced CT (45 of 651, 7%, p = 0.99 and p = 0.98 by one-sided t test). Multivariate regression modeling showed that only elevated baseline creatinine or decreased eGFR and low hematocrit/hemoglobin were associated with CIN incidence (odds ratio 1.28 and 2.5; p < 0.023 and <0.006, respectively). Conclusions: Elevation in serum creatinine due to intravenous and intra-arterial iodixanol administration is infrequent and is not more common than after unenhanced CT scans.

KW - Cardiac catheterization

KW - Contrast-induced nephropathy

KW - CT

KW - Intra-arterial

KW - Intravenous

KW - Renal

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