INTRODUCTION: Contrast-induced nephropathy (CIN) is the third most frequent source of hospital-acquired renal insufficiency. The investigation of factors and risks for CIN among patients who undergo non-coronary contrast procedures are less compared to coronary angiographic interventions.
OBJECTIVE: The aim of this study is to determine the rate and factors associated with the development of early CIN in patients who will undergo Contrast-Enhanced Computed Tomography (CECT) for non-coronary procedures.
METHODS: This is a prospective cohort study that included all patients admitted at UST Hospital for CECT of organs including coronary angiography from October 1, 2012 to October 31, 2015 (three-year study). All subjects received standard prophylaxis as recommended. CIN is present if there is elevation in the serum creatinine ? 0.5 mg/dL (44 umol/L) or a 25% rise above baseline creatinine level that is present from 24 to 48 hours after the study.
RESULTS: The cumulative incidence of CIN was at 2.0%, lower than other reported data. The diastolic blood pressure of the subjects who did not develop CIN were significantly higher than those who developed CIN (76.32 + 8.18 versus 67.50 + 5.00, mean difference = 8.82 + 4.15 mmHg, p = 0.038), such that a diastolic blood pressure of > 70 mmHg is associated with absence of CIN (p = 0.049). The development of CIN was not influenced by the procedure undertaken to study a particular organ nor the volume of contrast being used for the study. As expected, subjects with an estimated GFR of > 15 mL/min/1.73 m2 did not develop CIN (p=0.012).
CONCLUSION: The risk associated with early CIN in non-coronary CT scan procedures is minimal compared to interventions involving the coronaries. There is a significant association of diastolic blood pressure of > 70 mmHg and eGFR of ? 15 mL/min/1.73 m2 with non-development of CIN.