Keywords:
Kidney, Contrast agents, CT, Contrast agent-intravenous, Transplantation
Authors:
J. M. Gutiérrez, M. C. Sebastia, B. Miquel, L. Buñesch, L. Peri, C. Nicolau; Barcelona/ES
DOI:
10.1594/ecr2013/C-1555
Conclusion
Only two patients had a significant increase in creatinine levels compatible with CIN,
but showing no persistent worsening in renal function.
This increase may be related to the use of iodinated contrast,
but a number of studies have reported an increase in creatinine level in patients who do not receive contrast material similar to that reported in series of patient receiving contrast material (10).
The patient who required dialysis 37 days after the angio-CT scan had no significant increase in creatinine levels compatible with NIC and the requirement for dialysis was due to the natural course of his renal disease and the impossibility of performing the living-donor transplantation.
The increase in creatinine levels observed between the day of the procedure and the levels at 15 days could be attributed to the progression of the disease itself,
because they are not significantly different when compared with creatinine levels measured 15 days before the angio-CT.
However,
a larger sample size is needed to confirm these results.
The use of contrast media combined with prophylaxis with sodium bicarbonate and n-acetylcisteine in patients with end-stage renal disease will not induce an early start of dialysis.
CIN appeared only in 9.5% of patients,
with only a transient raise of creatinine and without permanent worsening of renal function.