Langner S, Stumpe S, Kirsch M, Petrik M, Hosten N
Institute for Diagnostic Radiology and Neuroradiology Ernst-Moritz-Arndt-University Greifswald, Greifswald, Germany.
AJNR Am J Neuroradiol. 2008 Sep;29(8):1525-9. doi: 10.3174/ajnr.A1164. Epub 2008 Jun 4.
Contrast-induced nephropathy (CIN) is one of the most common causes of in-hospital acute renal failure. The aim of this study was to assess the risk for CIN after repeated administration of the nonionic, dimeric, iso-osmolal contrast agent iodixanol regardless of pre-existing renal function. Changes in serum creatinine (SCr) levels were compared with those of control subjects who did not receive iodinated contrast media (CM).
Between January 2005 and March 2007, a total of 100 consecutive patients were prospectively included. Patients underwent a CT perfusion (CTP) study of the brain from clinical signs of acute cerebral infarction. CTP was performed with an intravenous bolus of 60 mL of iodixanol-270. Precontrast and postcontrast SCr levels were obtained, and the CTP study was repeated within 32 hours and postcontrast SCR was assessed. The control group consisted of 100 patients scheduled for plain cranial CT examination, who were not exposed to iodinated CM.
Mean baseline SCr level was 0.96 +/- 0.35 mg/dL in the contrast group and 1.14 +/- 0.74 mg/dL in the control group. After repeated administration of CM, a total of 7 patients had a relative increase of greater than or equal to 25% compared with baseline. In the control group, a relative increase of 25% or more was seen in 12 patients. The difference in the incidence of the rise in SCr of >25% was not significantly different (P = .094).
Multiple contrast-enhanced studies with intravenously administered iodixanol are not associated with a higher risk for CIN compared with a control group receiving no CM.
对比剂肾病(CIN)是院内急性肾衰竭最常见的病因之一。本研究旨在评估无论肾功能如何,重复使用非离子型、二聚体、等渗对比剂碘克沙醇后发生CIN的风险。将血清肌酐(SCr)水平的变化与未接受碘化对比剂(CM)的对照组受试者进行比较。
2005年1月至2007年3月,前瞻性纳入了连续100例患者。根据急性脑梗死的临床症状,患者接受了脑部CT灌注(CTP)研究。CTP通过静脉推注60 mL碘克沙醇-270进行。获取对比剂注射前和注射后的SCr水平,并在32小时内重复进行CTP研究并评估注射对比剂后的血清肌酐水平。对照组由100例计划进行头颅平扫CT检查且未接触碘化对比剂的患者组成。
对比剂组的平均基线SCr水平为0.96±0.35 mg/dL,对照组为1.14±0.74 mg/dL。重复使用对比剂后,共有7例患者与基线相比相对升高≥25%。在对照组中,12例患者出现了25%或更高的相对升高。SCr升高>25%的发生率差异无统计学意义(P = 0.094)。
与未接受对比剂的对照组相比,静脉注射碘克沙醇进行多次对比增强研究与CIN风险升高无关。