Incidence of contrast-induced nephropathy in hospitalised patients with cancer

• Published in: European radiology 2014, Vol.24 (1), p.184-190
• Main Authors: Cicin, Irfan, Erdogan, Bulent, Gulsen, Emrah, Uzunoglu, Sernaz, Sut, Necdet, Turkmen, Esma, Kodaz, Hilmi, Ustundag, Sedat
• Format: Article
• Language: English
• Subjects: Abdomen; Adult; Anemia; Cancer therapies; Chemotherapy; Computed Tomography; Contrast Media - adverse effects; Creatinine; Diagnostic Radiology; Drugs; Female; Humans; Hypertension; Imaging; Incidence; Inpatients; Internal Medicine; Interventional Radiology; Iohexol - adverse effects; Iohexol - analogs & derivatives; Kidney Diseases - chemically induced; Kidney Diseases - epidemiology; Male; Medicine; Medicine & Public Health; Middle Aged; Neoplasms - diagnostic imaging; Neuroradiology; Oncology; Patients; Prospective Studies; Radiology; Risk Factors; Tomography; Tomography, X-Ray Computed - adverse effects; Tomography, X-Ray Computed - methods; Turkey - epidemiology; Ultrasound
• ISSN: 0938-7994; 1432-1084
• DOI: 10.1007/s00330-013-2996-6

Objectives To determine the frequency of and possible factors related to contrast-induced nephropathy (CIN) in hospitalised patients with cancer. Methods Ninety adult patients were enrolled. Patients with risk factors for acute renal failure were excluded. Blood samples were examined the day before contrast-enhanced computed tomography (CT) and serially for 3 days thereafter. CIN was defined as an increase in serum creatinine (Cr) of 0.5 mg/dl or more, or elevation of Cr to 25 % over baseline. Relationships between CIN and possible risk factors were investigated. Results CIN was detected in 18/90 (20 %) patients. CIN developed in 25.5 % patients who underwent chemotherapy and in 11 % patients who did not ( P  = 0.1). CIN more frequently developed in patients who had undergone CT within 45 days after the last chemotherapy ( P =  0.005); it was also an independent risk factor ( P  = 0.017). CIN was significantly more after treatment with bevacizumab/irinotecan ( P  = 0.021) and in patients with hypertension ( P  = 0.044). Conclusions The incidence of CIN after CT in hospitalised oncological patients was 20 %. CIN developed 4.5-times more frequently in patients with cancer who had undergone recent chemotherapy. Hypertension and the combination of bevacizumab/irinotecan may be additional risk factors for CIN development. Key Points • Contrast-induced nephropathy (CIN) is a concern for oncological patients undergoing CT. • CIN occurs more often when CT is performed