Meta-analysis: Serum creatinine changes following contrast enhanced CT imaging

Abstract Purpose Contrast induced nephropathy (CIN) is defined as a decrease in renal function following administration of contrast media. The aim of this meta-analysis was to asses the overall risk of CIN, chronic loss of kidney function and the need for renal replacement therapy (RRT) after intrav...

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Bibliographic Details
Published in:European journal of radiology 2012-10, Vol.81 (10), p.2554-2561
Main Authors: Kooiman, Judith, Pasha, Sharif M, Zondag, Wendy, Sijpkens, Yvo W.J, van der Molen, Aart J, Huisman, Menno V, Dekkers, Olaf M
Format: Article
Language:English
Subjects:
Acute kidney injury
Biomarkers - blood
Computed tomography
Contrast Media
Creatinine - blood
Drug-Related Side Effects and Adverse Reactions - blood
Drug-Related Side Effects and Adverse Reactions - epidemiology
Humans
Prevalence
Radiology
Renal insufficiency
Renal Insufficiency, Chronic - blood
Renal Insufficiency, Chronic - epidemiology
Renal replacement therapy
Reproducibility of Results
Risk Assessment
Sensitivity and Specificity
Tomography, X-Ray Computed - statistics & numerical data
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Summary:Abstract Purpose Contrast induced nephropathy (CIN) is defined as a decrease in renal function following administration of contrast media. The aim of this meta-analysis was to asses the overall risk of CIN, chronic loss of kidney function and the need for renal replacement therapy (RRT) after intravenous contrast enhanced CT-scan. Secondly, we aimed to identify subgroups at increased risk for CIN. Materials and methods A literature search in Pubmed, Medline, Embase and Cochrane databases was performed. Data extraction was carried out independently by two reviewers. Meta-analysis and meta-regression were performed using an exact likelihood approach. Results Forty studies evaluating the incidence of CIN after CT were included. The pooled incidence of CIN was 6.4% (95% CI 5.0–8.1). The risk of RRT after CIN was low, 0.06% (95% CI 0.01–0.4). The decline in renal function persisted in 1.1% of patients (95% CI 0.6–2.1%). Patients with chronic kidney disease (odds ratio 2.26, p < 0.001) or diabetes mellitus (odds ratio 3.10, p < 0.001) were at increased risk for the development of CIN. Conclusion CIN occurred in 6% of patients after contrast enhanced CT. In 1% of all patients undergoing contrast enhanced CT the decline in renal function persisted.
ISSN:0720-048X
1872-7727
DOI:10.1016/j.ejrad.2011.11.020