title: Renal assessment using CKD-EPI equation is useful as an early predictor of contrast- induced nephropathy in elderly patients with cancer.
abstract: To assess respective roles of serum creatinine (SCr) alone and estimated glomerular filtration rate (eGFR) as an early predictor for contrast-induced nephropathy (CIN) in elderly patients with cancer.
  
  
  
  eGFR of 348 patients at 65years or older with malignancy who underwent contrast-enhanced computed tomography (CECT) were calculated. eGFR was calculated based on the following three equations: Chronic Kidney Disease Epidemiology Collaboration equation (CKD-EPI); Modification of Diet in Renal Disease Study (MDRD); Cockcroft-Gault (CG). CIN was subdivided into two groups: CIN25%(SCr increase >25% but ≤0.5mg/dl), and CIN0.5(SCr increase >0.5mg/dl). The occurrence and clinical outcomes of CIN were determined according to SCr and eGFR.
  
  
  
  After CECT, CIN occurred in 50 (14.4%) patients, including 33 CIN25%patients and 17 CIN0.5patients. CIN0.5was significantly correlated with prolonged hospitalizations and increased in-hospital mortality, but not CIN25%. Despite SCr<1.5mg/dl, preexisting renal insufficiency (RI) was observed in 47 (13.5%) patients based on CKD-EPI equation, 50 (14.4%) patients based on MDRD equation, and 144 (41.4%) patients based on CG formula. In preexisting RI, the prevalence of CIN0.5had an odds ratio of 15.02 (5.24 to 43.07) based on CKD-EPI equation, 13.73 (4.81 to 39.20) based on MDRD equation, and 5.03 (1.60 to 15.75) based on CG formula.
  
  
  
  In elderly patients with cancer who visit the emergency department, renal assessment before CECT using CKD-EPI equation was superior to SCr alone, MDRD equation, or CG formula in predicting the occurrence of CIN related CECT.
authors.affiliation: Department of Emergency Medicine, College of Medicine, Yeungnam University, Daegu, Republic of Korea.
authors.forename: Sin-Youl
authors.initials: SY
authors.lastname: Park
authors.affiliation: Department of Emergency Medicine, Catholic University of Daegu School of Medicine, Daegu, Republic of Korea. Electronic address: turtle072@hanmail.net.
authors.forename: Kyung-Woo
authors.initials: KW
authors.lastname: Lee
mesh_terms: D058186:Acute Kidney Injury / Q000097:blood / Q000139:chemically induced* / Q000175:diagnosis; D000368:Aged; D000465:Algorithms; D003287:Contrast Media / Q000009:adverse effects*; D003404:Creatinine / Q000097:blood; D005260:Female; D005919:Glomerular Filtration Rate; D017052:Hospital Mortality; D006801:Humans; D007902:Length of Stay; D016015:Logistic Models; D008297:Male; D009369:Neoplasms / Q000000981:diagnostic imaging*; D011379:Prognosis; D016016:Proportional Hazards Models; D014057:Tomography, X-Ray Computed
chemical_list: D003287:Contrast Media; D003404:Creatinine
keywords: Chronic Kidney Disease Epidemiology Collaboration equation; Cockcroft-Gault formula; Contrast-induced nephropathy; Elderly patient with cancer; Estimated glomerular filtration rate; Modification of Diet in Renal Disease Study equation; Renal insufficiency