title: Contrast-induced nephropathy in patients with active cancer undergoing contrast-enhanced computed tomography.
abstract: OBJECTIVE
  This study was performed to measure the incidence and identify potential predictors of contrast-induced nephropathy (CIN) in cancer patients without chronic kidney disease and with normal or near-normal baseline serum creatinine measures who underwent contrast-enhanced computed tomography (CECT). Severity of CIN was reported based on the RIFLE (risk, injury, failure, loss of kidney function, and end-stage renal disease) classification of acute kidney injury.
  
  
  METHODS
  A retrospective analysis was performed on 820 cancer patients who presented at our emergency department from October 2014 to March 2015. CIN was defined as an increase in creatinine concentration of ≥0.5 mg/dL or ≥25 % above baseline that occurred 48 to 72 h after CECT.
  
  
  RESULTS
  The incidence of CIN was 8.0%. Serial CT examination [odds ratio (OR) 4.09; 95% confidence interval (CI) 1.34-12.56], hypotension before the CT scan (OR 3.95; 95% CI 1.77-8.83), liver cirrhosis (OR 2.82; 95% CI 1.06-7.55), BUN/creatinine >20 (OR 2.54; 95% CI 1.44-4.46), and peritoneal carcinomatosis (OR 1.75; 95% CI 1.01-3.00) were independently associated with CIN. Of 66 CIN patients, 44 met any of the severity criteria of the RIFLE classification. Five of these patients died during hospitalization but only one death was related to renal failure.
  
  
  CONCLUSIONS
  Even when the baseline serum creatinine is ≤1.5 mg/dL, a significant portion of cancer patients are still at risk of CIN. Consecutive CECT examinations, hypotension before CT, liver cirrhosis, dehydration, and peritoneal carcinomatosis seem to predispose patients to CIN.
authors.affiliation: Department of Emergency Medicine, Cancer Emergency Room, Asan Medical Center, University of Ulsan College of Medicine, 388-1 Pungnap-dong, Songpa-gu, Seoul, 138-736, Korea.
authors.forename: Seok-In
authors.initials: SI
authors.lastname: Hong
authors.affiliation: Department of Emergency Medicine, Cancer Emergency Room, Asan Medical Center, University of Ulsan College of Medicine, 388-1 Pungnap-dong, Songpa-gu, Seoul, 138-736, Korea. ans1023@gmail.com.
authors.forename: Shin
authors.initials: S
authors.lastname: Ahn
authors.affiliation: Department of Emergency Medicine, Cancer Emergency Room, Asan Medical Center, University of Ulsan College of Medicine, 388-1 Pungnap-dong, Songpa-gu, Seoul, 138-736, Korea.
authors.forename: Yoon-Seon
authors.initials: YS
authors.lastname: Lee
authors.affiliation: Department of Emergency Medicine, Cancer Emergency Room, Asan Medical Center, University of Ulsan College of Medicine, 388-1 Pungnap-dong, Songpa-gu, Seoul, 138-736, Korea.
authors.forename: Won Young
authors.initials: WY
authors.lastname: Kim
authors.affiliation: Department of Emergency Medicine, Cancer Emergency Room, Asan Medical Center, University of Ulsan College of Medicine, 388-1 Pungnap-dong, Songpa-gu, Seoul, 138-736, Korea.
authors.forename: Kyung Soo
authors.initials: KS
authors.lastname: Lim
authors.affiliation: Department of Emergency Medicine, Cancer Emergency Room, Asan Medical Center, University of Ulsan College of Medicine, 388-1 Pungnap-dong, Songpa-gu, Seoul, 138-736, Korea.
authors.forename: Jae Ho
authors.initials: JH
authors.lastname: Lee
authors.affiliation: Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors.forename: Jae-Lyun
authors.initials: JL
authors.lastname: Lee
mesh_terms: D058186:Acute Kidney Injury / Q000139:chemically induced*; D003287:Contrast Media / Q000009:adverse effects*; D003404:Creatinine / Q000097:blood*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications*; D012189:Retrospective Studies; D012307:Risk Factors; D014057:Tomography, X-Ray Computed / Q000379:methods*
chemical_list: D003287:Contrast Media; D003404:Creatinine
keywords: Cancer; Computed tomography; Contrast-induced nephropathy; Serum creatinine