title: Meta-analysis: serum creatinine changes following contrast enhanced CT imaging.
abstract: OBJECTIVE
  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.
  
  
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Thrombosis and Haemostasis, LUMC, Leiden, The Netherlands. j.kooiman@lumc.nl
authors.forename: Judith
authors.initials: J
authors.lastname: Kooiman
authors.forename: Sharif M
authors.initials: SM
authors.lastname: Pasha
authors.forename: Wendy
authors.initials: W
authors.lastname: Zondag
authors.forename: Yvo W J
authors.initials: YW
authors.lastname: Sijpkens
authors.forename: Aart J
authors.initials: AJ
authors.lastname: van der Molen
authors.forename: Menno V
authors.initials: MV
authors.lastname: Huisman
authors.forename: Olaf M
authors.initials: OM
authors.lastname: Dekkers
mesh_terms: D015415:Biomarkers / Q000097:blood; D003287:Contrast Media; D003404:Creatinine / Q000097:blood*; D064420:Drug-Related Side Effects and Adverse Reactions / Q000097:blood* / Q000453:epidemiology*; D006801:Humans; D015995:Prevalence; D051436:Renal Insufficiency, Chronic / Q000097:blood* / Q000453:epidemiology*; D015203:Reproducibility of Results; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000706:statistics & numerical data*
chemical_list: D015415:Biomarkers; D003287:Contrast Media; D003404:Creatinine