Risk of contrast-induced nephropathy in hospitalized patients with cirrhosis
Open Access
- 1 January 2009
- journal article
- Published by Baishideng Publishing Group Inc. in World Journal of Gastroenterology
- Vol. 15 (12), 1459-1464
- https://doi.org/10.3748/wjg.15.1459
Abstract
AIM: To evaluate the incidence of contrast-induced nephropathy (CIN) in cirrhotic patients and to identify risk factors for the development of CIN. METHODS: We performed a retrospective review of 216 consecutive patients with cirrhosis who underwent computed tomography (CT) with intravenous contrast at the University of Rochester between the years 2000-2005. We retrospectively examined factors associated with a high risk for CIN, defined as a decrease in creatinine clearance of 25% or greater within one week after receiving contrast. RESULTS: Twenty-five percent of our patients developed CIN, and 74% of these patients had ascites seen on CT. Of the 75% of patients who did not develop CIN, only 46% had ascites. The presence of ascites was a significant risk factor for the development of CIN (P = 0.0009, OR 3.38, 95% CI 1.55-7.34) in multivariate analysis. Patient age, serum sodium, Model for End-stage Liver Disease score, diuretic use, and the presence of diabetes were not found to be significant risk factors for the development of CIN. Of the patients who developed CIN, 11% developed chronic renal insufficiency, defined as a creatinine clearance less than baseline for 6 wk. CONCLUSION: Our results suggest that in hospitalized cirrhotic patients, especially those with ascites, the risk of CIN is substantial.Keywords
This publication has 52 references indexed in Scilit:
- Incidence of Contrast-Induced Nephropathy with Volume Supplementation – Insights from a Large CohortMedical Principles and Practice, 2008
- Analysis of glomerular filtration rate, serum cystatin C levels, and renal resistive index values in cirrhosis patientscclm, 2007
- Acute renal failure induced by contrast medium: steps towards preventionBMJ, 2006
- MELD score and clinical type predict prognosis in hepatorenal syndrome: Relevance to liver transplantationHepatology, 2005
- Contrast-Induced nephropathy after percutaneous coronary interventions in relation to chronic kidney disease and hemodynamic variablesThe American Journal of Cardiology, 2005
- A simple risk score for prediction of contrast-induced nephropathy after percutaneous coronary interventionJournal of the American College of Cardiology, 2004
- Pathophysiology of Radiocontrast NephropathyInvestigative Radiology, 1999
- Impact of acute renal failure on mortality in end-stage liver disease with or without transplantationKidney International, 1998
- Oxidant mechanisms in toxic acute renal failureAmerican Journal of Kidney Diseases, 1997
- Contrast Material-Induced Renal Failure in Patients with Diabetes Mellitus, Renal Insufficiency, or BothNew England Journal of Medicine, 1989