Incidence of contrast-induced nephropathy in hospitalised patients with cancer

Eur Radiol. 2014 Jan;24(1):184-90. doi: 10.1007/s00330-013-2996-6. Epub 2013 Sep 25.

Abstract

Objectives: To determine the frequency of and possible factors related to contrast-induced nephropathy (CIN) in hospitalised patients with cancer.

Methods: Ninety adult patients were enrolled. Patients with risk factors for acute renal failure were excluded. Blood samples were examined the day before contrast-enhanced computed tomography (CT) and serially for 3 days thereafter. CIN was defined as an increase in serum creatinine (Cr) of 0.5 mg/dl or more, or elevation of Cr to 25 % over baseline. Relationships between CIN and possible risk factors were investigated.

Results: CIN was detected in 18/90 (20 %) patients. CIN developed in 25.5 % patients who underwent chemotherapy and in 11 % patients who did not (P = 0.1). CIN more frequently developed in patients who had undergone CT within 45 days after the last chemotherapy (P = 0.005); it was also an independent risk factor (P = 0.017). CIN was significantly more after treatment with bevacizumab/irinotecan (P = 0.021) and in patients with hypertension (P = 0.044).

Conclusions: The incidence of CIN after CT in hospitalised oncological patients was 20 %. CIN developed 4.5-times more frequently in patients with cancer who had undergone recent chemotherapy. Hypertension and the combination of bevacizumab/irinotecan may be additional risk factors for CIN development.

Key points: • Contrast-induced nephropathy (CIN) is a concern for oncological patients undergoing CT. • CIN occurs more often when CT is performed <45 days after chemotherapy. • Hypertension and treatment with bevacizumab appear to be additional risk factors.

Publication types

  • Observational Study

MeSH terms

  • Adult
  • Contrast Media / adverse effects*
  • Female
  • Humans
  • Incidence
  • Inpatients*
  • Iohexol / adverse effects
  • Iohexol / analogs & derivatives
  • Kidney Diseases / chemically induced
  • Kidney Diseases / epidemiology*
  • Male
  • Middle Aged
  • Neoplasms / diagnostic imaging*
  • Prospective Studies
  • Risk Factors
  • Tomography, X-Ray Computed / adverse effects*
  • Tomography, X-Ray Computed / methods
  • Turkey / epidemiology

Substances

  • Contrast Media
  • Iohexol
  • iopromide