title: Increased risk of contrast-induced acute kidney injury in patients with pulmonary thromboembolism.
abstract: BACKGROUND
  Computed tomography pulmonary angiography (CTPA) is currently an effective, reliable and widely employed diagnostic test for pulmonary thromboembolism (PT). PT harbors intrinsic clinical and biochemical abnormalities which may be associated with an increased risk of contrast-induced acute kidney injury (CIAKI).
  
  
  OBJECTIVE
  To assess the incidence and risk factors of CIAKI among patients with PT diagnosed with CTPA.
  
  
  METHODS
  One hundred and twenty-two consecutive patients who had been diagnosed with PT using CTPA between February 2006 and December 2010 were evaluated retrospectively. In addition to the classical risk factors of CIAKI, arterial blood gases, CTPA and transthoracic echocardiography findings of the patients were also recorded.
  
  
  RESULTS
  The incidence of CIAKI was 13.1%. There were statistically important differences with respect to age, the presence of congestive heart failure (CHF), the use of angiotensin converting enzyme inhibitor-angiotensin II receptor blocker drugs (ACEI-ARB), the arterial blood pH (ABpH) and the length of hospitalization between the two groups of patients who developed (n:16) and did not develop (n:106) CIAKI. In the logistic regression analysis, age and ABpH were preserved in the final equation.
  
  
  CONCLUSIONS
  The incidence of CIAKI among PT patients is significantly higher than the expected average. Older age, the presence of CHF, the use of ACEI-ARB, and additionally, low ABpH are important risk factors of CIAKI in patients with PT. Hypoxemia and low bicarbonate levels intrinsic to PT may contribute to the increased risk of CIAKI in this patient population and their correction may carry a prophylactic potential.
authors.affiliation: a Polatlı Duatepe State Hospital , Ankara , Turkey .
authors.forename: Sahin
authors.initials: S
authors.lastname: Doganay
authors.affiliation: b Department of Internal Medicine , Ufuk University School of Medicine , Ankara , Turkey , and.
authors.forename: Ali Kemal
authors.initials: AK
authors.lastname: Oguz
authors.affiliation: c Division of Nephrology , Department of Internal Medicine, Ufuk University School of Medicine , Ankara , Turkey.
authors.forename: Ihsan
authors.initials: I
authors.lastname: Ergun
mesh_terms: D058186:Acute Kidney Injury / Q000139:chemically induced*; D000368:Aged; D000369:Aged, 80 and over; D000792:Angiography / Q000009:adverse effects* / Q000379:methods; D003287:Contrast Media / Q000009:adverse effects*; D003404:Creatinine / Q000097:blood; D004452:Echocardiography; D005260:Female; D005919:Glomerular Filtration Rate / Q000502:physiology; D006801:Humans; D015994:Incidence; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011655:Pulmonary Embolism / Q000175:diagnosis*; D012189:Retrospective Studies; D012307:Risk Factors; D014057:Tomography, X-Ray Computed / Q000379:methods*
chemical_list: D003287:Contrast Media; D003404:Creatinine
keywords: Acute kidney injury; angiography; bicarbonate ion; computed tomography; contrast media; pulmonary thromboembolism