Section of Nephrology, VA Loma Linda Healthcare System.
Ther Clin Risk Manag. 2010 May 25;6:213-7. doi: 10.2147/tcrm.s10198.
Exposure to radiocontrast media may result in acute kidney injury (AKI) or traditionally defined contrast nephropathy (CN), both of which may lead to increased morbidity and mortality. The pathogenesis of both these variants of contrast-induced nephropathy (CIN) may involve inflammatory mediators that lead to renal impairment. A link between obesity and inflammation has been clearly established, but whether obesity is independently associated with CIN is unknown.
To determine whether obesity, when stratified by body mass index (BMI), is a risk factor for CIN in a large and hemodynamically stable population of hospitalized United States veterans.
Retrospective chart review.
Presence or absence of AKI or CN after intravenous radiocontrast administration and comparison of patient characteristics between those with versus without AKI or CN.
The overall prevalence of AKI and CN was 16.1% and 12.6%, respectively. Patients with AKI or CN were comparable to those without radiocontrast injury, except that affected patients tended to be older and diabetic. When stratified by BMI, obesity was not found to be associated with the development of AKI or CN after exposure to radiocontrast.
Obesity does not appear to be an independent risk factor for AKI or CN after exposure to radiocontrast.
接触造影剂可能导致急性肾损伤（AKI）或传统定义的造影剂肾病（CN），两者均可导致发病率和死亡率增加。这两种造影剂诱导的肾病（CIN）变体的发病机制都可能涉及导致肾功能损害的炎症介质。肥胖与炎症之间的联系已经得到明确证实，但肥胖是否与 CIN 独立相关尚不清楚。
确定肥胖（按体重指数（BMI）分层）是否是美国住院退伍军人这一大且血流动力学稳定人群中 CIN 的危险因素。
回顾性图表审查。
静脉内造影剂给药后 AKI 或 CN 的存在或不存在，并比较有 AKI 或 CN 与无 AKI 或 CN 患者的特征。
AKI 和 CN 的总体患病率分别为 16.1%和 12.6%。发生 AKI 或 CN 的患者与未发生造影剂损伤的患者相似，只是受影响的患者年龄更大且患有糖尿病。按 BMI 分层时，肥胖与接触造影剂后发生 AKI 或 CN 无关。
肥胖似乎不是接触造影剂后发生 AKI 或 CN 的独立危险因素。
