title: Exposure to radiologic contrast media and an increased risk of treated end-stage renal disease.
abstract: BACKGROUND
  Radiologic contrast media can cause acute renal failure, but whether their repeated use is associated with end-stage renal disease (ESRD) is unknown.
  
  
  METHODS
  We compared 716 incident case subjects of treated ESRD with 361 control subjects, frequency matched on age, drawn from the general population (age, 20-65 years). Participants were interviewed by telephone regarding their previous exposure (before initiation of dialysis for case subjects and the study interview for control subject) to various imaging procedures.
  
  
  RESULTS
  As expected, the case subjects reported having more imaging procedures of the kidneys than did control subjects. Excluding persons who had been subjected to examinations of their kidney from the analysis and adjusting for ultrasound examinations and several possible confounders, persons who had a history of one [odds ratio (OR), 2.0; 95% confidence interval (CI), 1.0, 4.0], 2 or 3 (OR, 2.6; 95% CI, 1.2,5.9), or 4 or more (OR, 3.6; 95% CI, 1.0, 12.5) radiocontrast examinations were at higher risk of treated ESRD than persons who reported not having had such procedures. Ultrasound examinations and a history of barium enema were not associated with an increased risk of treated ESRD.
  
  
  CONCLUSIONS
  In the current study, a graded association was present between increasing exposure to radiologic contrast media and higher risk of treated ESRD. Whether exposure to contrast media accelerates progression to ESRD or is merely a noncausal accompaniment to multiple disease processes occurring concurrently cannot be determined from our observational data. However, if these results are confirmed in future prospective studies, they will have important clinical implications.
authors.affiliation: Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, Louisiana 70112, USA. pmuntner@tulane.edu
authors.forename: Paul
authors.initials: P
authors.lastname: Muntner
authors.forename: Josef
authors.initials: J
authors.lastname: Coresh
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Klag
authors.forename: Paul K
authors.initials: PK
authors.lastname: Whelton
authors.forename: Thomas V
authors.initials: TV
authors.lastname: Perneger
mesh_terms: D000328:Adult; D000368:Aged; D016001:Confidence Intervals; D003287:Contrast Media / Q000008:administration & dosage / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000139:chemically induced* / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D012307:Risk Factors; D014463:Ultrasonography
chemical_list: D003287:Contrast Media