Nephropathy in critically Ill patients without preexisting renal disease.
Contrast-induced nephropathy (CIN) remains a common complication of radiographic procedures. Isovue (lopamidol) is a low-osmolality nonionic monomeric tri-iodinated water soluble agent widely used as a contrast medium in radiographic procedures for intravascular, intrathecal, and body cavity administration. The purpose of this study was to evaluate the effect of lopamidol on renal function in patients without any preexisting renal condition who were undergoing radiographic imaging with the iodine contrast. Seventy-five patients admitted to the Intensive Care Unit (ICU) had CT-scans with intravenous lopamidol contrast. All the patients had a normal serum creatinine before administration of the contrast media. Serum creatinine was recorded for three consecutive days after the CT-scan. The control group consisted of medical ICU patients that were not administered iodine contrast during their stay in the unit. There was no change from the baseline in the control group. A significant increase in serum creatinine was recorded in patients undergoing CT-scan with lopamidol contrast. In 18% of the patients, creatinine was elevated more than 25% from the baseline. This level of creatinine elevation indicated a significant decrease in glomerular filtration, and thus fulfilled the criteria for contrast-induced nephropathy. Our data demonstrates that iodine contrast media for CT in ICU patients without preexisting kidney disease can precipitate clearly measurable nephropathic changes.
Polena
Sotir
S
Flushing Hospital Medical Center, Flushing, NY, USA.
Yang
Stephen
S
Alam
Rabi
R
Gricius
Jonas
J
Gupta
J Rahul
JR
Badalova
Nadezhda
N
Chuang
Peter
P
Gintautas
Jonas
J
Conetta
Rick
R
D000368:Aged; D003287:Contrast Media / Q000009:adverse effects*; D003404:Creatinine / Q000097:blood; D016638:Critical Illness; D005260:Female; D006801:Humans; D007483:Iothalamic Acid / Q000009:adverse effects*; D007674:Kidney Diseases / Q000139:chemically induced* / Q000453:epidemiology; D007677:Kidney Function Tests; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed
D003287:Contrast Media; D007483:Iothalamic Acid; D003404:Creatinine