title: Acute kidney injury in cirrhotic patients undergoing contrast-enhanced computed tomography.
abstract: Contrast medium administration is one of the leading causes of acute kidney injury (AKI) in different clinical settings. The aim of the study was to investigate occurrence and predisposing factors of AKI in cirrhotic patients undergoing contrast-enhanced computed tomography (CECT).Datasets of 1279 consecutively hospitalized cirrhotic patients were retrospectively analyzed. Two hundred forty-nine of 1279 patients (mean age 64 ± 11 years, 165 male) who had undergone CECT were selected on the basis of the availability of serum creatinine (sCr) values evaluated before and after CECT (CECT group). In analogy, 203/1279 cases (mean age 66 ± 10 years, 132 male) who had not undergone CECT and had been tested twice for sCr in 7 days were also included as controls (Control group). AKI network criteria were employed to assess contrast-induced AKI (CI-AKI) development. Apart from lack of narrowed double sCr measurements, additional exclusion criteria were active bacterial infections, nephrotoxic drugs intake, and estimated glomerular filtration rate <30 mL/min.AKI developed in 22/249 (8.8%) and in 6/203 (3%) of the CECT and the Control groups, respectively (P = 0.01). The multivariate logistic regression analysis showed that AKI was significantly associated with contrast medium administration (odds ratio [OR]: 3.242, 95% confidence interval [CI]: 1.255-8.375; P = 0.015), female sex (OR: 0.339, 95% CI: 0.139-0.827; P = 0.017), and sCr values (OR: 0.124, 95% CI: 0.016-0.975; P = 0.047). In the CECT group, presence of ascites (OR: 2.796, 95% CI: 1.109-7.052; P = 0.029), female sex (OR: 0.192, 95% CI: 0.073-0.510; P = 0.001), and hyperazotemia (OR: 1.018, 95% CI: 1.001-1.037; P = 0.043) correlated with CI-AKI development at multivariate analysis.CI-AKI is a quite frequent occurrence in cirrhotic patients with female sex, presence of ascites, and hyperazotemia being the predisposing factors.
authors.affiliation: Department of Internal Medicine Division of Clinical and Molecular Hepatology Department of Clinical and Experimental Medicine, University Hospital of Messina Department of Economics, University of Messina Department of Diagnostic Imaging and Radiotherapy Department of Biomedical Sciences and Morphological and Functional Imaging Department of Human Pathology of Adult and Evolutive Age, University Hospital of Messina, Messina, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Filomia
authors.forename: Sergio
authors.initials: S
authors.lastname: Maimone
authors.forename: Gaia
authors.initials: G
authors.lastname: Caccamo
authors.forename: Carlo
authors.initials: C
authors.lastname: Saitta
authors.forename: Luca
authors.initials: L
authors.lastname: Visconti
authors.forename: Angela
authors.initials: A
authors.lastname: Alibrandi
authors.forename: Simona
authors.initials: S
authors.lastname: Caloggero
authors.forename: Antonio
authors.initials: A
authors.lastname: Bottari
authors.forename: Maria Stella
authors.initials: MS
authors.lastname: Franzè
authors.forename: Carmine Gabriele
authors.initials: CG
authors.lastname: Gambino
authors.forename: Tindaro
authors.initials: T
authors.lastname: Lembo
authors.forename: Giovanni
authors.initials: G
authors.lastname: Oliva
authors.forename: Irene
authors.initials: I
authors.lastname: Cacciola
authors.forename: Giovanni
authors.initials: G
authors.lastname: Raimondo
authors.forename: Giovanni
authors.initials: G
authors.lastname: Squadrito
mesh_terms: D058186:Acute Kidney Injury / Q000139:chemically induced* / Q000453:epidemiology; D000368:Aged; D001201:Ascites / Q000209:etiology; D053099:Azotemia / Q000209:etiology; D003287:Contrast Media / Q000008:administration & dosage / Q000009:adverse effects*; D003404:Creatinine / Q000097:blood; D005260:Female; D006801:Humans; D007677:Kidney Function Tests; D008103:Liver Cirrhosis / Q000097:blood / Q000150:complications / Q000000981:diagnostic imaging*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012737:Sex Factors; D014057:Tomography, X-Ray Computed / Q000009:adverse effects* / Q000379:methods
chemical_list: D003287:Contrast Media; D003404:Creatinine