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Acute and long-term...
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Berglund, FelixUppsala universitet,Radiologi
(author)
Acute and long-term renal effects after iodine contrast media-enhanced computerised tomography in the critically ill-a retrospective bi-centre cohort study.
- Article/chapterEnglish2024
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LIBRIS-ID:oai:DiVA.org:uu-514018
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https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-514018URI
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https://doi.org/10.1007/s00330-023-10059-7DOI
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Language:English
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Summary in:English
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Subject category:ref swepub-contenttype
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Subject category:art swepub-publicationtype
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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.
Subject headings and genre
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Acute kidney injury
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Contrast media
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Critical care
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Tomography
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X-ray computed
Added entries (persons, corporate bodies, meetings, titles ...)
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Eilertz, EbbaUppsala universitet,Institutionen för kirurgiska vetenskaper
(author)
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Nimmersjö, FredrikUppsala universitet,Institutionen för kirurgiska vetenskaper
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Wolf, AdamUppsala universitet,Institutionen för kirurgiska vetenskaper
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Nordlander, ChristopherUppsala universitet,Institutionen för kirurgiska vetenskaper
(author)
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Palm, Fredrik
(author)
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Parenmark, Fredric
(author)
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Westerbergh, Johan
(author)
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Liss, PerUppsala universitet,Radiologi(Swepub:uu)perliss
(author)
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Frithiof, RobertUppsala universitet,Anestesiologi och intensivvård(Swepub:uu)robfr118
(author)
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Uppsala universitetRadiologi
(creator_code:org_t)
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In:European Radiology34:3, s. 1736-17450938-79941432-1084
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Eilertz, Ebba
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Nimmersjö, Fredr ...
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Palm, Fredrik
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