title: Clinical Significance of Persistent Global and Focal Computed Tomography Nephrograms After Cardiac Catheterization and Their Relationships to Urinary Biomarkers of Kidney Damage and Procedural Factors: Pilot Study.
abstract: We evaluate the relationships between persistent computed tomography (CT) nephrograms and acute kidney injury after cardiac catheterization (CC). We compare changes in urinary biomarkers kidney injury molecule 1 (KIM-1), cystatin C, and serum creatinine to procedural factors.
  
  
  
  From 159 eligible patients without renal insufficiency (estimated glomerular filtration rate >60 mL/min), 40 random patients (age range, 42-81 years; mean age, 64 years; 25 men, 15 women) gave written informed consent to undergo unenhanced CT limited to their kidneys 24 hours after CC. Semiquantitative assessment for global nephrograms and quantitative assessment of focal nephrograms in each kidney was performed. Computed tomography attenuation (Hounsfield units) of the renal cortex was measured. Serum creatinine, KIM-1, and cystatin C were measured before and 24 hours after CC.
  
  
  
  Robust linear regression showed that both relative changes in KIM-1 and cystatin C had positive relationships with kidney CT attenuation (P = 0.012 and 0.002, respectively). Spearman rank correlation coefficient showed that both absolute changes and relative changes in KIM-1 and cystatin C had positive correlations with global nephrogram grades (P = 0.025 and 0.040, respectively, for KIM-1; P = 0.013 and 0.019, respectively, for cystatin C).
  
  
  
  Global nephrograms on unenhanced CT in patients who have undergone CC are significantly correlated with changes in urinary biomarkers for kidney damage.
authors.affiliation: From the *Department of Radiology, University of California Davis Medical Center, Sacramento; †Department of Radiology, University of California San Francisco, San Francisco, CA; ‡Department of Radiology and Radiological Sciences, Medical University of South Carolina, Charleston, SC; §Division of Nephrology and Hypertension, Department of Medicine, University of Vermont Medical Center, Burlington, VT; ∥Department of Cardiology, University of California Davis Medical Center; ¶Division of Biostatistics, Department of Public Health Sciences School of Medicine, University of California Davis, Sacramento, CA; #Department of Radiology, Mayo Clinic, Rochester, MN; and **Division of Nephrology-Hypertension, Department of Medicine, University of California San Diego, San Diego, CA; and ††Department of Cell Biology and Molecular Genetics, Devaraj Urs Medical College and Hospital, Kolar, Karnataka, India.
authors.forename: Lisa L
authors.initials: LL
authors.lastname: Chu
authors.forename: Richard W
authors.initials: RW
authors.lastname: Katzberg
authors.forename: Richard
authors.initials: R
authors.lastname: Solomon
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Southard
authors.forename: Scott J
authors.initials: SJ
authors.lastname: Evans
authors.forename: Chin-Shang
authors.initials: CS
authors.lastname: Li
authors.forename: Jennifer S
authors.initials: JS
authors.lastname: McDonald
authors.forename: Catherine
authors.initials: C
authors.lastname: Payne
authors.forename: John M
authors.initials: JM
authors.lastname: Boone
authors.forename: Satish P
authors.initials: SP
authors.lastname: RamachandraRao
mesh_terms: D058186:Acute Kidney Injury / Q000652:urine*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000652:urine; D006328:Cardiac Catheterization; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007668:Kidney / Q000000981:diagnostic imaging*; D007677:Kidney Function Tests; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D014057:Tomography, X-Ray Computed / Q000009:adverse effects* / Q000379:methods*
chemical_list: D015415:Biomarkers