Contrast-induced nephropathy in aged critically ill patients

Oxid Med Cell Longev. 2014:2014:756469. doi: 10.1155/2014/756469. Epub 2014 Jan 28.

Abstract

Background: Aging is associated with renal structural changes and functional decline. The attributable risk for renal dysfunction from radiocontrast agents in critically ill older patients has not been well established.

Methods: In this prospective study, we assessed the incidence of contrast-induced nephropathy (CIN) in critically ill patients with stable renal function who underwent computed tomography with intravenous contrast media. Patients were categorized into two age groups: <65 (YG) or ≥ 65 years old (OG). CIN was defined as 25% or greater increase from baseline of serum creatinine or as an absolute increase by 0.5 mg/dL until the 5th day after the infusion of contrast agent. We also evaluated the alterations in oxidative stress by assessing serum 8-isoprostane.

Results: CIN occurred in 5 of 13 OG patients (38.46%) whereas no YG patient presented CIN (P = 0.015). Serum creatinine kinetics in older patients demonstrated a rise over five days following contrast infusion time while a decline was observed in the YG (P = 0.005).

Conclusions: Older critically ill patients are more prone to develop renal dysfunction after the intravenous infusion of contrast agent in relation to their younger counterparts.

Publication types

  • Observational Study

MeSH terms

  • Adult
  • Aging / blood
  • Aging / pathology*
  • Contrast Media / adverse effects*
  • Creatinine / blood
  • Critical Illness*
  • Dinoprost / analogs & derivatives
  • Dinoprost / blood
  • Female
  • Humans
  • Kidney Diseases / blood
  • Kidney Diseases / chemically induced*
  • Kidney Diseases / epidemiology*
  • Male
  • Urea / blood

Substances

  • Contrast Media
  • 8-epi-prostaglandin F2alpha
  • Urea
  • Creatinine
  • Dinoprost