Azzouz Manal, Rømsing Janne, Thomsen Henrik S
Department of Diagnostic Radiology, Copenhagen University Hospital Herlev, Herlev Ringvej 75, DK 2730 Herlev, Denmark.
Department of Drug Design and Pharmacology, University of Copenhagen, Universitetsparken 2, DK-2100 Copenhagen Ø, Denmark.
Eur J Radiol. 2014 Jun;83(6):886-892. doi: 10.1016/j.ejrad.2014.02.014. Epub 2014 Feb 24.
To study fluctuations in estimated glomerular filtration rate (eGFR) in relation to contrast medium (CM) enhanced magnetic resonance imaging (MRI) and computed tomography (CT) compared to control groups in outpatients.
eGFR was determined right before the imaging procedure and three days later at the department or at the patient's home. The iodine-based and gadolinium-based contrast media were the same as used for all other examinations at the department.
A total of 716 patients completed the study. There was a statistically significant, but not clinically relevant rise in eGFR after three days in all four groups. The average eGFR variation was 4.8 ml/min/1.73 m(2). There were large variations in eGFR between the two measurements in 45.8% of the patients as they had a change greater than ± 10 ml/min/1.73 m(2). Only three patients fulfilled the contrast-induced nephropathy (CIN) requirement when the definition s-creatinine ≥ 44 μmol/l (0.5mg/dl) was used.
eGFR in outpatients undergoing MRI or CT did vary independently of whether the patient received contrast or not. The findings probably reflect the natural variations in s-creatinine levels. This should be taken into consideration when CIN is studied.
研究门诊患者中，与对照组相比，估计肾小球滤过率（eGFR）相对于造影剂（CM）增强磁共振成像（MRI）和计算机断层扫描（CT）的波动情况。
在成像检查前及检查后三天，于科室或患者家中测定eGFR。碘基和钆基造影剂与科室所有其他检查所用造影剂相同。
共有716例患者完成研究。所有四组患者在三天后eGFR均有统计学上显著但无临床意义的升高。平均eGFR变化为4.8 ml/min/1.73 m²。45.8%的患者两次测量的eGFR存在较大差异，因为其变化大于±10 ml/min/1.73 m²。当使用血清肌酐≥44 μmol/l（0.5mg/dl）的定义时，仅有三名患者符合造影剂肾病（CIN）标准。
接受MRI或CT检查的门诊患者的eGFR确实会独立于患者是否接受造影剂而发生变化。这些发现可能反映了血清肌酐水平的自然波动。在研究CIN时应考虑到这一点。
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