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Acute and long-term...
Acute and long-term renal effects after iodine contrast media-enhanced computerised tomography in the critically ill-a retrospective bi-centre cohort study.
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- Berglund, Felix (författare)
- Uppsala universitet,Radiologi
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- Eilertz, Ebba (författare)
- Uppsala universitet,Institutionen för kirurgiska vetenskaper
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- Nimmersjö, Fredrik (författare)
- Uppsala universitet,Institutionen för kirurgiska vetenskaper
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- Wolf, Adam (författare)
- Uppsala universitet,Institutionen för kirurgiska vetenskaper
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- Nordlander, Christopher (författare)
- Uppsala universitet,Institutionen för kirurgiska vetenskaper
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Palm, Fredrik (författare)
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Parenmark, Fredric (författare)
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Westerbergh, Johan (författare)
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- Liss, Per (författare)
- Uppsala universitet,Radiologi
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- Frithiof, Robert (författare)
- Uppsala universitet,Anestesiologi och intensivvård
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(creator_code:org_t)
- 2024
- 2024
- Engelska.
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Ingår i: European Radiology. - 0938-7994 .- 1432-1084. ; 34:3, s. 1736-1745
- Relaterad länk:
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https://urn.kb.se/re...
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https://doi.org/10.1...
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Abstract
Ämnesord
Stäng
- OBJECTIVES: To determine if current clinical use of iodine contrast media (ICM) for computerised tomography (CT) increases the risk of acute kidney injury (AKI) and long-term decline in renal function in patients treated in intensive care.METHODS: A retrospective bi-centre cohort study was performed with critically ill subjects undergoing either ICM-enhanced or unenhanced CT. AKI was defined and staged based on the Kidney Disease Improve Global Outcome AKI criteria, using both creatinine and urine output criteria. Follow-up plasma creatinine was recorded three to six months after CT to assess any long-term effects of ICM on renal function.RESULTS: In total, 611 patients were included in the final analysis, median age was 65.0 years (48.0-73.0, quartile 1-quartile 3 (IQR)) and 62.5% were male. Renal replacement therapy was used post-CT in 12.9% and 180-day mortality was 31.2%. Plasma creatinine level on day of CT was 100.0 µmol/L (66.0-166.5, IQR) for non-ICM group and 77.0 µmol/L (59.0-109.0, IQR) for the ICM group. The adjusted odds ratio for developing AKI if the patient received ICM was 1.03 (95% confidence interval 0.64-1.66, p = 0.90). No significant association between ICM and increase in plasma creatinine at long-term follow-up was found, with an adjusted effect size of 2.92 (95% confidence interval - 6.52-12.36, p = 0.543).CONCLUSIONS: The results of this study do not indicate an increased risk of AKI or long-term decline in renal function when ICM is used for enhanced CT in patients treated at intensive care units.CLINICAL RELEVANCE STATEMENT: Patients treated in intensive care units had no increased risk of acute kidney injury or persistent decline in renal function after contrast-enhanced CT. This information underlines the need for a proper risk-reward assessment before denying patients a contrast-enhanced CT.KEY POINTS: • Iodine contrast media is considered a risk factor for the development of acute kidney injury. • Patients receiving iodine contrast media did not have an increased incidence of acute kidney injury or persistent decline in renal function. • A more clearly defined risk of iodine contrast media helps guide clinical decisions whether to perform contrast-enhanced CTs or not.
Nyckelord
- Acute kidney injury
- Contrast media
- Critical care
- Tomography
- X-ray computed
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- art (ämneskategori)
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Till lärosätets databas
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Berglund, Felix
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Eilertz, Ebba
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Nimmersjö, Fredr ...
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Wolf, Adam
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Nordlander, Chri ...
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Palm, Fredrik
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visa fler...
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Parenmark, Fredr ...
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Westerbergh, Joh ...
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Liss, Per
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Frithiof, Robert
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visa färre...
- Artiklar i publikationen
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European Radiolo ...
- Av lärosätet
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Uppsala universitet