Findings on intraprocedural non-contrast computed tomographic imaging following hepatic artery embolization are associated with development of contrast-induced nephropathy

Debkumar Sarkar; Ilya Glezerman; Majid Maybody; Mohamed M Soliman

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Findings on intraprocedural non-contrast computed tomographic imaging following hepatic artery embolization are associated with development of contrast-induced nephropathy

Findings on intraprocedural non-contrast computed tomographic imaging following hepatic artery embolization are associated with development of contrast-induced nephropathy

作者：

Debkumar Sarkar Ilya Glezerman Majid Maybody Mohamed M Soliman

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Hepatic

artery

embolization

Non-contrast

computed

tomographic

Contrastinduced

nephropathy

Renal

enhancement

pattern

INTRA-ARTERIAL

Renal

artery

calcification

摘要：

BACKGROUND Contrast-induced nephropathy(CIN)is a reversible form of acute kidney injury that occurs within 48-72 h of exposure to intravascular contrast material.CIN is the third leading cause of hospital-acquired acute kidney injury and accounts for 12%of such cases.Risk factors for CIN development can be divided into patientand procedure-related.The former includes pre-existing chronic renal insufficiency and diabetes mellitus.The latter includes high contrast volume and repeated exposure over 72 h.The incidence of CIN is relatively low(up to 5%)in patients with intact renal function.However,in patients with known chronic renal insufficiency,the incidence can reach up to 27%.AIM To examine the association between renal enhancement pattern on non-contrast enhanced computed tomographic(CT)images obtained immediately following hepatic artery embolization with development of CIN.METHODS Retrospective review of all patients who underwent hepatic artery embolization between 01/2010 and 01/2011(n=162)was performed.Patients without intraprocedural CT imaging(n=51),combined embolization/ablation(n=6)and those with chronic kidney disease(n=21)were excluded.The study group comprised of 84 patients with 106 procedures.CIN was defined as 25%increase above baseline serum creatinine or absolute increase≥0.5 mg/dL within 72 h post-embolization.Post-embolization CT was reviewed for renal enhancement patterns and presence of renal artery calcifications.The association between noncontrast CT findings and CIN development was examined by Fisher’s Exact Test.RESULTS CIN occurred in 11/106(10.3%)procedures(Group A,n=10).The renal enhancement pattern in patients who did not experience CIN(Group B,n=74 with 95/106 procedures)was late excretory in 93/95(98%)and early excretory(EE)in 2/95(2%).However,in Group A,there was a significantly higher rate of EE pattern(6/11,55%)compared to late excretory pattern(5/11)(P<0.001).A significantly higher percentage of patients that developed CIN had renal artery calcifications(6/11 vs 20/95,55%v

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篇名	Findings on intraprocedural non-contrast computed tomographic imaging following hepatic artery embolization are associated with development of contrast-induced nephropathy
来源期刊	世界肾病学杂志:英文版	学科	医学
关键词	Hepatic artery embolization Non-contrast computed tomographic Contrastinduced nephropathy Renal enhancement pattern INTRA-ARTERIAL Renal artery calcification
年，卷（期）	2020,（2）	所属期刊栏目
研究方向		页码范围	33-42
页数	10页	分类号	R73
字数		语种
DOI