Evidence map›Paper›PMID 33159575›Full record

ArticleEuropean radiology2021

Cumulative iodinated contrast exposure for computed tomography during acute kidney injury and major adverse kidney events.

Horng-Ruey Chua, Sanmay Low, Tanusya Murali Murali, Emmett Tsz-Yeung Wong, Hai-Dong He, Boon-Wee Teo, Yee-Liang Thian, K Akalya, Anantharaman Vathsala

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Article in European radiology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
0.4field-weighted citation impact, top 36% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 8 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 4 institutions in 2 countries.

Horng-Ruey ChuaDivision of Nephrology, Department of Medicine, National University Hospital, Level 10, NUHS Tower Block, 1E Kent Ridge Road, 119228, Singapore, Singapore. horng_ruey_chua@nuhs.edu.sg.ORCID http://orcid.org/0000-0003-1379-0585
Sanmay LowDivision of Renal Medicine, Department of Medicine, Ng Teng Fong General Hospital, Singapore, Singapore.
Tanusya Murali MuraliDepartment of Microbiology and Immunology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
Emmett Tsz-Yeung WongDivision of Nephrology, Department of Medicine, National University Hospital, Level 10, NUHS Tower Block, 1E Kent Ridge Road, 119228, Singapore, Singapore.
Hai-Dong HeDepartment of Nephrology, Shanghai Minhang District Central Hospital, Shanghai, People's Republic of China.
Boon-Wee TeoDivision of Nephrology, Department of Medicine, National University Hospital, Level 10, NUHS Tower Block, 1E Kent Ridge Road, 119228, Singapore, Singapore.
Yee-Liang ThianDepartment of Diagnostic Imaging, National University Hospital, Singapore, Singapore.
K AkalyaDivision of Nephrology, Department of Medicine, National University Hospital, Level 10, NUHS Tower Block, 1E Kent Ridge Road, 119228, Singapore, Singapore.
Anantharaman VathsalaDivision of Nephrology, Department of Medicine, National University Hospital, Level 10, NUHS Tower Block, 1E Kent Ridge Road, 119228, Singapore, Singapore.
National University of Singapore · SGNational University Hospital · SGMinhang District Central Hospital · CNNg Teng Fong General Hospital · SG

Funding

National Kidney Foundation of Singapore NKFRC2014/01/14
6 · The paper itself

Abstract

objectivesTo determine if contrast-enhanced CT imaging performed in patients during their episode of AKI contributes to major adverse kidney events (MAKE).

methodsA propensity score-matched analysis of 1127 patients with AKI defined by KDIGO criteria was done. Their mean age was 63 ± 16 years with 56% males. A total of 419 cases exposed to CT contrast peri-AKI were matched with 798 non-exposed controls for 14 covariates including comorbidities, acute illnesses, and initial AKI severity; outcomes including MAKE and renal recovery in hospital were compared using bivariate analysis and logistic regression. MAKE was a composite of mortality, renal replacement therapy, and doubling of serum creatinine on discharge over baseline; renal recovery was classified as early versus late based on a 7-day timeline from AKI onset to nadir creatinine or cessation of renal replacement therapy in survivors.

resultsSixty-two patients received cumulatively > 100 mL of CT contrast, 143 patients had > 50-100 mL, and 214 patients had 50 mL or less; MAKE occurred in 34%, 17%, and 21%, respectively, as compared with 20% in non-exposed controls (p = 0.008 for patients with > 100 mL contrast versus none). More contrast-exposed patients experienced late renal recovery (27% versus 20%) and longer hospital days (median 10 versus 8) than non-exposed patients (all p < 0.01). On multivariate analysis, cumulative CT contrast > 100 mL was independently associated with MAKE (odds ratio 2.39 versus non-contrast, adjusted for all confounders, p = 0.005); cumulative CT contrast under 100 mL was not associated with MAKE.

conclusionsHigh cumulative volume of CT contrast administered to patients with AKI is associated with worse short-term renal outcomes and delayed renal recovery. KEY POINTS: • Cumulative intravenous iodinated contrast for CT imaging of more than 100 mL, during an episode of acute kidney injury, was independently associated with worse renal outcomes and less renal recovery. • These adverse outcomes including renal replacement therapy were not more frequent in similar patients who received cumulatively 100 mL or less of CT contrast, compared with non-exposed patients. • More patients with CT contrast exposure during acute kidney injury experienced delayed renal recovery.

Indexed as

Acute Kidney InjuryAgedFemaleHumansKidneyMaleMiddle AgedRetrospective StudiesRisk FactorsTomography, X-Ray ComputedAcute kidney injuryComputed tomographyContrast mediaRadiographyRenal replacement therapy

Identifiers

PMID33159575
OpenAlexW3097122359

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.