Palli Eleni, Makris Demosthenes, Papanikolaou John, Garoufalis Grigorios, Zakynthinos Epaminondas
Department of Critical Care, Surgical Department, University Hospital of Larissa, Biopolis, 41110 Larissa, Greece.
Oxid Med Cell Longev. 2014;2014:756469. doi: 10.1155/2014/756469. Epub 2014 Jan 28.
Aging is associated with renal structural changes and functional decline. The attributable risk for renal dysfunction from radiocontrast agents in critically ill older patients has not been well established.
In this prospective study, we assessed the incidence of contrast-induced nephropathy (CIN) in critically ill patients with stable renal function who underwent computed tomography with intravenous contrast media. Patients were categorized into two age groups: <65 (YG) or ≥ 65 years old (OG). CIN was defined as 25% or greater increase from baseline of serum creatinine or as an absolute increase by 0.5 mg/dL until the 5th day after the infusion of contrast agent. We also evaluated the alterations in oxidative stress by assessing serum 8-isoprostane.
CIN occurred in 5 of 13 OG patients (38.46%) whereas no YG patient presented CIN (P = 0.015). Serum creatinine kinetics in older patients demonstrated a rise over five days following contrast infusion time while a decline was observed in the YG (P = 0.005).
Older critically ill patients are more prone to develop renal dysfunction after the intravenous infusion of contrast agent in relation to their younger counterparts.
衰老与肾脏结构改变和功能衰退相关。危重症老年患者因使用造影剂导致肾功能不全的归因风险尚未明确。
在这项前瞻性研究中，我们评估了接受静脉注射造影剂的计算机断层扫描且肾功能稳定的危重症患者中对比剂肾病（CIN）的发生率。患者被分为两个年龄组：<65岁（年轻组）或≥65岁（老年组）。CIN定义为血清肌酐较基线水平升高25%或更多，或在注射造影剂后第5天血清肌酐绝对值升高0.5mg/dL。我们还通过评估血清8-异前列腺素评估氧化应激的变化。
13例老年组患者中有5例（38.46%）发生CIN，而年轻组患者均未发生CIN（P=0.015）。老年患者的血清肌酐动力学在造影剂注射后5天呈上升趋势，而年轻组则呈下降趋势（P=0.005）。
与年轻的危重症患者相比，老年危重症患者静脉注射造影剂后更容易发生肾功能不全。
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