title: Repeated Contrast Administration Is Associated With Low Risk of Postcontrast Acute Kidney Injury and Long-Term Complications in Patients With Severe Chronic Kidney Disease.
abstract: Patients with chronic kidney disease (CKD) frequently require radiographic examinations. We investigated the impact of repeated contrast administrations on short- and long-term kidney function and mortality in kidney transplantation candidates. In a prospective study, 81 predialysis transplantation candidates underwent computed tomography angiography (CTA) and invasive coronary angiography (ICA) as part of a pretransplant cardiovascular evaluation. Postcontrast plasma creatinine (P-creatinine) changes were compared with a precontrast control period. We identified postcontrast acute kidney injury (AKI) in 10 patients (13%) after CTA and in two patients (3%) after ICA. Compared with the control period, relative changes in P-creatinine were significantly higher after CTA (p < 0.001) and ICA (p < 0.01). Diabetic kidney failure (p < 0.05) and contrast dose >0.8 mL/kg (p < 0.001) were associated with increases in P-creatinine. All cases of postcontrast AKI were reversible, and we found no differences between the progression rates of the kidney failure during 12 months before and after contrast exposure (p = 0.56). In a Cox regression analysis, creatinine changes after CTA or ICA were not associated with increased need for dialysis treatment or mortality. Contrast exposure and transient postcontrast AKI did not increase the risk of accelerated CKD progression or the time to initiation of dialysis or death.
authors.affiliation: Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark.|Department of Internal Medicine, Hospital Unit West, Herning, Denmark.
authors.forename: S
authors.initials: S
authors.lastname: Winther
authors.affiliation: Department of Nephrology, Aarhus University Hospital, Aarhus, Denmark.
authors.forename: M
authors.initials: M
authors.lastname: Svensson
authors.affiliation: Department of Nephrology, Aarhus University Hospital, Aarhus, Denmark.
authors.forename: H S
authors.initials: HS
authors.lastname: Jørgensen
authors.affiliation: Department of Nephrology, Aarhus University Hospital, Aarhus, Denmark.|Department of Biomedicine, Aarhus University, Aarhus, Denmark.
authors.forename: H
authors.initials: H
authors.lastname: Birn
authors.affiliation: Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark.
authors.forename: H E
authors.initials: HE
authors.lastname: Bøtker
authors.affiliation: Department of Nephrology, Aarhus University Hospital, Aarhus, Denmark.
authors.forename: P
authors.initials: P
authors.lastname: Ivarsen
authors.affiliation: Department of Internal Medicine, Hospital Unit West, Herning, Denmark.
authors.forename: M
authors.initials: M
authors.lastname: Bøttcher
mesh_terms: D058186:Acute Kidney Injury / Q000209:etiology*; D000328:Adult; D000368:Aged; D003287:Contrast Media / Q000008:administration & dosage / Q000009:adverse effects*; D017023:Coronary Angiography / Q000379:methods; D003404:Creatinine / Q000097:blood; D005260:Female; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate; D006084:Graft Rejection; D006085:Graft Survival; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery; D007677:Kidney Function Tests; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011379:Prognosis; D011446:Prospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D014057:Tomography, X-Ray Computed / Q000379:methods
chemical_list: D003287:Contrast Media; D003404:Creatinine
keywords: clinical research; practice