Long-term effect of radiocontrast-enhanced computed tomography on the renal function of chronic kidney disease patients.

BACKGROUND

The risk of acute kidney injury produced by intravenous radiocontrast in patients with chronic kidney disease (CKD) has been well known, but little is known about the long-term effects on renal function.

METHODS

We retrospectively reviewed the medical records of 176 CKD patients with estimated glomerular filtration rates (eGFR) <60 ml/min/1.73 m(2) who underwent computed tomography (CT) with intravenous radiocontrast at Pusan National University Hospital. Patients were divided into 3 groups (CKD stage 3, n = 104; CKD stage 4, n = 52; peritoneal dialysis, n = 20). Follow-up eGFR values were assessed on a monthly basis for up to 8 months.

RESULTS

In baseline characteristics, there were no significant differences between the 3 groups (i.e., CKD stage 3, stage 4, and PD) in the variables of age, sex, presence of diabetes and follow-up period. There were no significant differences between eGFR before and after CT in all patients and each of the 3 investigated groups. In each group, data analysis according to the presence of diabetes mellitus (DM) did not show significant differences of eGFR before and after CT.

CONCLUSION

Overall, these results illustrate that intravenous contrast media used in the standard CT scan have no significant long-term effects on renal function in CKD patients, irrespective of DM. Therefore, from a long-term perspective, contrast-enhanced CT might be a better option than gadolinium-based magnetic resonance imaging, which is known to be associated with fatal nephrogenic systemic fibrosis in CKD patients.