title: Use of cystatin C and serum creatinine for the diagnosis of contrast-induced nephropathy in patients undergoing contrast-enhanced computed tomography at an oncology centre.
abstract: OBJECTIVE
  Our aim was to assess renal function using as laboratory measurements serum creatinine and cystatin C concentrations before and after administration of low-osmolarity (nonionic) iodinated contrast medium in patients with cancer undergoing computed tomography (CT).
  
  
  METHODS
  This prospective study included 400 oncologic outpatients. Serum creatinine and cystatin C concentrations were measured before and 72 h after contrast administration. Glomerular filtration rates (GFRs) were estimated using serum creatinine-based [Modification of Diet in Renal Disease (MDRD) and Cockroft-Gault and cystatin C based (Larsson) equations. Exploratory data analysis was performed. The nonparametric Wilcoxon test was used to compare pre and post contrast of test results and estimated clearance. The confidence interval used in the analysis was 95%.
  
  
  RESULTS
  Compared with the pre-contrast values, the mean serum creatinine concentration was significantly higher and average GFRs estimated using MDRD and Cockcroft-Gault equations were significantly lower after the administration of contrast (p <0.001). It was also observed a significant increase after contrast in the concentration of Cystatin C (p = 0.015). In addition, a decrease in GFR estimated using the average Larsson (p = 0.021) was observed between time points. However, none of the patients presented clinically significant nephropathy.
  
  
  CONCLUSIONS
  Assessment using serum creatinine and cystatin C concentrations showed changes in renal function among patients with cancer undergoing contrast-enhanced CT examination in this study. No significant renal damage related to the use of low-osmolarity iodinated contrast medium of the type and dosage employed in this study was observed. This contrast medium is thus safe for use in patients with cancer.
authors.affiliation: Department of Imaging - AC Camargo Cancer Center, São Paulo-SP, Brazil.
authors.forename: Joao Italo
authors.initials: JI
authors.lastname: Fortalesa Melo
authors.affiliation: Department of Imaging - AC Camargo Cancer Center, São Paulo-SP, Brazil.
authors.forename: Rubens
authors.initials: R
authors.lastname: Chojniak
authors.affiliation: Department of Imaging - AC Camargo Cancer Center, São Paulo-SP, Brazil.
authors.forename: Debora Helena
authors.initials: DH
authors.lastname: Costa Silva
authors.affiliation: Department of Imaging - AC Camargo Cancer Center, São Paulo-SP, Brazil.
authors.forename: Jose Carlos
authors.initials: JC
authors.lastname: Oliveira Junior
authors.affiliation: Department of Imaging - AC Camargo Cancer Center, São Paulo-SP, Brazil.
authors.forename: Almir Galvão
authors.initials: AG
authors.lastname: Vieira Bitencourt
authors.affiliation: Department of Imaging - AC Camargo Cancer Center, São Paulo-SP, Brazil.
authors.forename: Diego
authors.initials: D
authors.lastname: Holanda Silva
authors.affiliation: Department of Imaging - AC Camargo Cancer Center, São Paulo-SP, Brazil.
authors.forename: Marcos Duarte
authors.initials: MD
authors.lastname: Guimarães
authors.affiliation: Department of Imaging - AC Camargo Cancer Center, São Paulo-SP, Brazil.
authors.forename: Hernandes Cerqueira Souza
authors.initials: HC
authors.lastname: Silva
authors.affiliation: Department of Imaging - AC Camargo Cancer Center, São Paulo-SP, Brazil.
authors.forename: Denis Guilherme Teixeira
authors.initials: DG
authors.lastname: Dias
authors.affiliation: Department of Imaging - AC Camargo Cancer Center, São Paulo-SP, Brazil.
authors.forename: Winglison Carli
authors.initials: WC
authors.lastname: Rodrigues
authors.affiliation: Department of Imaging - AC Camargo Cancer Center, São Paulo-SP, Brazil.
authors.forename: Ellen Luzia
authors.initials: EL
authors.lastname: Brancucci
authors.affiliation: Department of Clinical Pathology - AC Camargo Cancer Center, São Paulo-SP, Brazil.
authors.forename: Barbara Martins Soares
authors.initials: BM
authors.lastname: Cruz
authors.affiliation: Department of Clinical Pathology - AC Camargo Cancer Center, São Paulo-SP, Brazil.
authors.forename: Beatriz Nunes
authors.initials: BN
authors.lastname: Schiavon
authors.affiliation: Statistical Nucleos - Campinas University School of Medicine, Campinas-SP, Brazil.
authors.forename: Juliana Luz Passos
authors.initials: JL
authors.lastname: Argenton
authors.affiliation: Department of Imaging - AC Camargo Cancer Center, São Paulo-SP, Brazil.
authors.forename: Margareth Arrivabene
authors.initials: MA
authors.lastname: Camporini
authors.affiliation: Department of Imaging - AC Camargo Cancer Center, São Paulo-SP, Brazil.
authors.forename: Adriana
authors.initials: A
authors.lastname: Zocchio
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003287:Contrast Media / Q000009:adverse effects*; D003404:Creatinine / Q000097:blood*; D055316:Cystatin C / Q000097:blood*; D005260:Female; D054879:Halogenation; D006801:Humans; D007668:Kidney / Q000187:drug effects / Q000503:physiopathology; D007674:Kidney Diseases / Q000097:blood / Q000139:chemically induced* / Q000175:diagnosis* / Q000503:physiopathology; D007677:Kidney Function Tests; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D014057:Tomography, X-Ray Computed / Q000009:adverse effects; D055815:Young Adult
chemical_list: D003287:Contrast Media; D055316:Cystatin C; D003404:Creatinine