title: Anemia and the risk of contrast-induced nephropathy in patients with renal insufficiency undergoing contrast-enhanced MDCT.
abstract: OBJECTIVE
  The purpose of this study was to assess the effect of anemia on the incidence of contrast-induced nephropathy (CIN) in patients with renal impairment undergoing MDCT.
  
  
  METHODS
  Institutional review board approval was waived for this retrospective review of 843 patients with stable renal insufficiency (eGFR between 15 and 60 mL/min) who had undergone contrast-enhanced MDCT. Baseline hematocrit and hemoglobin values were measured. Serum creatinine (SCr) was assessed at the baseline and at 48-72 h after contrast administration.
  
  
  RESULTS
  The overall incidence of CIN in the patient population with renal insufficiency was 6.9%. CIN developed in 7.8% (54 of 695) of anemic patients, and in 2.8% (4 of 148) of non-anemic patients (P=.027). After adjustment for confounders, low hemoglobin and low hematocrit values remained independent predictors of CIN (odds ratio 4.6, 95% CI 1.0-20.5, P=.046).
  
  
  CONCLUSIONS
  Anemia is associated with a higher incidence of CIN in patients with renal insufficiency. Anemia is a potentially modifiable risk factor for CIN, and has an unfavorable impact on prognosis in patients with renal insufficiency undergoing contrast-enhanced MDCT.
authors.affiliation: Department of Radiology, Graduate School of Medicine, Nippon Medical School, Japan. rywakana@nms.ac.jp
authors.forename: Ryusuke
authors.initials: R
authors.lastname: Murakami
authors.forename: Shin-ichiro
authors.initials: S
authors.lastname: Kumita
authors.forename: Hiromitsu
authors.initials: H
authors.lastname: Hayashi
authors.forename: Ken-ichi
authors.initials: K
authors.lastname: Sugizaki
authors.forename: Emi
authors.initials: E
authors.lastname: Okazaki
authors.forename: Tomonari
authors.initials: T
authors.lastname: Kiriyama
authors.forename: Kenta
authors.initials: K
authors.lastname: Hakozaki
authors.forename: Hitomi
authors.initials: H
authors.lastname: Tani
authors.forename: Izumi
authors.initials: I
authors.lastname: Miki
authors.forename: Minako
authors.initials: M
authors.lastname: Takeda
mesh_terms: D058186:Acute Kidney Injury / Q000000981:diagnostic imaging / Q000453:epidemiology*; D000368:Aged; D000740:Anemia / Q000175:diagnosis / Q000453:epidemiology*; D015984:Causality; D015897:Comorbidity; D003287:Contrast Media; D064420:Drug-Related Side Effects and Adverse Reactions / Q000453:epidemiology*; D005260:Female; D006801:Humans; D015994:Incidence; D007472:Iohexol; D007564:Japan / Q000453:epidemiology; D007674:Kidney Diseases; D008297:Male; D051437:Renal Insufficiency / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D012189:Retrospective Studies; D012307:Risk Factors; D014057:Tomography, X-Ray Computed / Q000706:statistics & numerical data*
chemical_list: D003287:Contrast Media; D007472:Iohexol
keywords: Anemia; Contrast induced nephropathy; Contrast media; MDCT