title: Risk of contrast-induced nephropathy for patients receiving intravenous vs. intra-arterial iodixanol administration.
abstract: OBJECTIVE
  To compare the incidence of contrast-induced nephropathy (CIN) for intravenous vs. intra-arterial administration of iodixanol, compared to non-administration.
  
  
  METHODS
  We retrospectively identified 650 patients who had intravenous iodixanol-enhanced CT, 695 with intra-arterial iodixanol cardiac catheterization, 651 with unenhanced CT, and those who also had baseline and follow-up serum creatinine within 5 days of the exam. From the medical records, we recorded the gender, age, baseline and follow-up serum creatinine/eGFR; underlying renal injury risk factors; indication for imaging; contrast material administration volume, concentration, and route of administration; and use of pre-imaging prophylactic measures for CIN. Univariate and multivariate models were used to determine predictors of CIN.
  
  
  RESULTS
  Baseline eGFR was lower for patients undergoing unenhanced CT than intravenous or intra-arterial patients (68 vs. 74.6 and 72.2, respectively, p < 0.01) and not different between intravenous and intra-arterial patients (p = 0.735). Simple logistic regression did not show a difference in the rate of CIN in patients who received intravenous vs. intra-arterial iodixanol (28 of 650, 4%, vs. 28 of 695, 4%, respectively, p = 0.798), nor a higher rate of CIN than seen with unenhanced CT (45 of 651, 7%, p = 0.99 and p = 0.98 by one-sided t test). Multivariate regression modeling showed that only elevated baseline creatinine or decreased eGFR and low hematocrit/hemoglobin were associated with CIN incidence (odds ratio 1.28 and 2.5; p < 0.023 and <0.006, respectively).
  
  
  CONCLUSIONS
  Elevation in serum creatinine due to intravenous and intra-arterial iodixanol administration is infrequent and is not more common than after unenhanced CT scans.
authors.affiliation: Department of Radiology and Biomedical Imaging, University of California San Francisco, Box 0628, M-372, 505 Parnassus Avenue, San Francisco, CA, 94143-0628, USA.
authors.forename: Gregory E
authors.initials: GE
authors.lastname: Tong
authors.affiliation: Department of Radiology and Biomedical Imaging, University of California San Francisco, Box 0628, M-372, 505 Parnassus Avenue, San Francisco, CA, 94143-0628, USA.
authors.forename: Sant
authors.initials: S
authors.lastname: Kumar
authors.affiliation: Department of Radiology and Biomedical Imaging, University of California San Francisco, Box 0628, M-372, 505 Parnassus Avenue, San Francisco, CA, 94143-0628, USA.
authors.forename: Karen C
authors.initials: KC
authors.lastname: Chong
authors.affiliation: Department of Radiology and Biomedical Imaging, University of California San Francisco, Box 0628, M-372, 505 Parnassus Avenue, San Francisco, CA, 94143-0628, USA.
authors.forename: Nikita
authors.initials: N
authors.lastname: Shah
authors.affiliation: Department of Radiology and Biomedical Imaging, University of California San Francisco, Box 0628, M-372, 505 Parnassus Avenue, San Francisco, CA, 94143-0628, USA.
authors.forename: Margaret J
authors.initials: MJ
authors.lastname: Wong
authors.affiliation: Division of Cardiology, San Francisco Veterans Affairs Medical Center, 4150 Clement Avenue, San Francisco, CA, 94121, USA.
authors.forename: Jeffrey M
authors.initials: JM
authors.lastname: Zimmet
authors.affiliation: Department of Radiology and Biomedical Imaging, University of California San Francisco, Box 0628, M-372, 505 Parnassus Avenue, San Francisco, CA, 94143-0628, USA.
authors.forename: Zhen Jane
authors.initials: ZJ
authors.lastname: Wang
authors.affiliation: Department of Radiology and Biomedical Imaging, University of California San Francisco, Box 0628, M-372, 505 Parnassus Avenue, San Francisco, CA, 94143-0628, USA.
authors.forename: Judy
authors.initials: J
authors.lastname: Yee
authors.affiliation: Department of Radiology and Biomedical Imaging, University of California San Francisco, Box 0628, M-372, 505 Parnassus Avenue, San Francisco, CA, 94143-0628, USA.
authors.forename: Yanjun
authors.initials: Y
authors.lastname: Fu
authors.affiliation: Department of Radiology and Biomedical Imaging, University of California San Francisco, Box 0628, M-372, 505 Parnassus Avenue, San Francisco, CA, 94143-0628, USA. ben.yeh@ucsf.edu.
authors.forename: Benjamin M
authors.initials: BM
authors.lastname: Yeh
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006328:Cardiac Catheterization; D003287:Contrast Media / Q000008:administration & dosage / Q000009:adverse effects*; D003404:Creatinine / Q000097:blood; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007269:Injections, Intra-Arterial / Q000009:adverse effects; D007275:Injections, Intravenous / Q000009:adverse effects; D007674:Kidney Diseases / Q000139:chemically induced*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012306:Risk; D014057:Tomography, X-Ray Computed; D014283:Triiodobenzoic Acids / Q000008:administration & dosage / Q000009:adverse effects*
chemical_list: D003287:Contrast Media; D014283:Triiodobenzoic Acids; D003404:Creatinine; C044834:iodixanol
keywords: CT; Cardiac catheterization; Contrast-induced nephropathy; Intra-arterial; Intravenous; Renal