Mortality associated with nephropathy after radiographic contrast exposure

Aaron M. From, Brian Jack Bartholmai, Amy W. Williams, Stephen S. Cha, Furman S. McDonald

Research output: Contribution to journalArticle

119 Citations (Scopus)

Abstract

OBJECTIVE: To define outcomes from contrast-induced nephropathy (CIN) after both intra-arterial and intravenous administration of contrast medium. PATIENTS AND METHODS: We performed a retrospective case-matched cohort study at Mayo Clinic's site in Rochester, MN, from April 1, 2004, to March 31, 2006. All contrast procedures were evaluated for inclusion. Contrast-induced nephropathy was defined as creatinine elevation of 25% or more after contrast exposure or of more than 0.5 mg/dL within 7 days of contrast exposure. Cases of CIN were matched 1:3 with controls by age, sex, preprocedure creatinine elevation, diabetes mellitus, and type of imaging procedure. RESULTS: A total of 809 patients who developed CIN were matched to 2427 patients who did not develop CIN after contrast exposure. In multivariate analyses, CIN was significantly associated with 30-day mortality (odds ratio, 3.37; 95% confidence interval [CI], 2.58-4.41; P<.001) and overall mortality (hazard ratio, 1.57; 95% CI, 1.32-1.86; P<.001) after adjustment for heart failure, hypertension, medications, total hydration, iodine load, prior contrast exposure, and all matched variables during the study period. Intravenous contrast administration was a risk factor for 30-day mortality (odds ratio, 2.91; 95% CI, 1.17-7.23; P=.02) and overall mortality (hazard ratio, 3.02; 95% CI, 1.89-4.82; P<.001) compared with intra-arterial administration of contrast after adjustment for heart failure, hypertension, medications, total hydration, iodine load, prior contrast exposure, and all matched variables during the study period. CONCLUSION: Contrast-induced nephropathy after administration of contrast medium is associated with increased mortality. This risk is higher in patients in whom contrast medium is administered intravenously than in those in whom it is administered intraarterially.

Original languageEnglish (US)
Pages (from-to)1095-1100
Number of pages6
JournalMayo Clinic Proceedings
Volume83
Issue number10
DOIs
StatePublished - 2008

Fingerprint

Mortality
Confidence Intervals
Contrast Media
Iodine
Intravenous Administration
Creatinine
Heart Failure
Odds Ratio
Hypertension
Diabetes Mellitus
Cohort Studies
Multivariate Analysis

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Mortality associated with nephropathy after radiographic contrast exposure. / From, Aaron M.; Bartholmai, Brian Jack; Williams, Amy W.; Cha, Stephen S.; McDonald, Furman S.

In: Mayo Clinic Proceedings, Vol. 83, No. 10, 2008, p. 1095-1100.

Research output: Contribution to journalArticle

From, Aaron M. ; Bartholmai, Brian Jack ; Williams, Amy W. ; Cha, Stephen S. ; McDonald, Furman S. / Mortality associated with nephropathy after radiographic contrast exposure. In: Mayo Clinic Proceedings. 2008 ; Vol. 83, No. 10. pp. 1095-1100.
@article{119db21340d0469bba942b7d0ced4ad4,
title = "Mortality associated with nephropathy after radiographic contrast exposure",
abstract = "OBJECTIVE: To define outcomes from contrast-induced nephropathy (CIN) after both intra-arterial and intravenous administration of contrast medium. PATIENTS AND METHODS: We performed a retrospective case-matched cohort study at Mayo Clinic's site in Rochester, MN, from April 1, 2004, to March 31, 2006. All contrast procedures were evaluated for inclusion. Contrast-induced nephropathy was defined as creatinine elevation of 25{\%} or more after contrast exposure or of more than 0.5 mg/dL within 7 days of contrast exposure. Cases of CIN were matched 1:3 with controls by age, sex, preprocedure creatinine elevation, diabetes mellitus, and type of imaging procedure. RESULTS: A total of 809 patients who developed CIN were matched to 2427 patients who did not develop CIN after contrast exposure. In multivariate analyses, CIN was significantly associated with 30-day mortality (odds ratio, 3.37; 95{\%} confidence interval [CI], 2.58-4.41; P<.001) and overall mortality (hazard ratio, 1.57; 95{\%} CI, 1.32-1.86; P<.001) after adjustment for heart failure, hypertension, medications, total hydration, iodine load, prior contrast exposure, and all matched variables during the study period. Intravenous contrast administration was a risk factor for 30-day mortality (odds ratio, 2.91; 95{\%} CI, 1.17-7.23; P=.02) and overall mortality (hazard ratio, 3.02; 95{\%} CI, 1.89-4.82; P<.001) compared with intra-arterial administration of contrast after adjustment for heart failure, hypertension, medications, total hydration, iodine load, prior contrast exposure, and all matched variables during the study period. CONCLUSION: Contrast-induced nephropathy after administration of contrast medium is associated with increased mortality. This risk is higher in patients in whom contrast medium is administered intravenously than in those in whom it is administered intraarterially.",
author = "From, {Aaron M.} and Bartholmai, {Brian Jack} and Williams, {Amy W.} and Cha, {Stephen S.} and McDonald, {Furman S.}",
year = "2008",
doi = "10.4065/83.10.1095",
language = "English (US)",
volume = "83",
pages = "1095--1100",
journal = "Mayo Clinic Proceedings",
issn = "0025-6196",
publisher = "Elsevier Science",
number = "10",

}

TY - JOUR

T1 - Mortality associated with nephropathy after radiographic contrast exposure

AU - From, Aaron M.

AU - Bartholmai, Brian Jack

AU - Williams, Amy W.

AU - Cha, Stephen S.

AU - McDonald, Furman S.

PY - 2008

Y1 - 2008

N2 - OBJECTIVE: To define outcomes from contrast-induced nephropathy (CIN) after both intra-arterial and intravenous administration of contrast medium. PATIENTS AND METHODS: We performed a retrospective case-matched cohort study at Mayo Clinic's site in Rochester, MN, from April 1, 2004, to March 31, 2006. All contrast procedures were evaluated for inclusion. Contrast-induced nephropathy was defined as creatinine elevation of 25% or more after contrast exposure or of more than 0.5 mg/dL within 7 days of contrast exposure. Cases of CIN were matched 1:3 with controls by age, sex, preprocedure creatinine elevation, diabetes mellitus, and type of imaging procedure. RESULTS: A total of 809 patients who developed CIN were matched to 2427 patients who did not develop CIN after contrast exposure. In multivariate analyses, CIN was significantly associated with 30-day mortality (odds ratio, 3.37; 95% confidence interval [CI], 2.58-4.41; P<.001) and overall mortality (hazard ratio, 1.57; 95% CI, 1.32-1.86; P<.001) after adjustment for heart failure, hypertension, medications, total hydration, iodine load, prior contrast exposure, and all matched variables during the study period. Intravenous contrast administration was a risk factor for 30-day mortality (odds ratio, 2.91; 95% CI, 1.17-7.23; P=.02) and overall mortality (hazard ratio, 3.02; 95% CI, 1.89-4.82; P<.001) compared with intra-arterial administration of contrast after adjustment for heart failure, hypertension, medications, total hydration, iodine load, prior contrast exposure, and all matched variables during the study period. CONCLUSION: Contrast-induced nephropathy after administration of contrast medium is associated with increased mortality. This risk is higher in patients in whom contrast medium is administered intravenously than in those in whom it is administered intraarterially.

AB - OBJECTIVE: To define outcomes from contrast-induced nephropathy (CIN) after both intra-arterial and intravenous administration of contrast medium. PATIENTS AND METHODS: We performed a retrospective case-matched cohort study at Mayo Clinic's site in Rochester, MN, from April 1, 2004, to March 31, 2006. All contrast procedures were evaluated for inclusion. Contrast-induced nephropathy was defined as creatinine elevation of 25% or more after contrast exposure or of more than 0.5 mg/dL within 7 days of contrast exposure. Cases of CIN were matched 1:3 with controls by age, sex, preprocedure creatinine elevation, diabetes mellitus, and type of imaging procedure. RESULTS: A total of 809 patients who developed CIN were matched to 2427 patients who did not develop CIN after contrast exposure. In multivariate analyses, CIN was significantly associated with 30-day mortality (odds ratio, 3.37; 95% confidence interval [CI], 2.58-4.41; P<.001) and overall mortality (hazard ratio, 1.57; 95% CI, 1.32-1.86; P<.001) after adjustment for heart failure, hypertension, medications, total hydration, iodine load, prior contrast exposure, and all matched variables during the study period. Intravenous contrast administration was a risk factor for 30-day mortality (odds ratio, 2.91; 95% CI, 1.17-7.23; P=.02) and overall mortality (hazard ratio, 3.02; 95% CI, 1.89-4.82; P<.001) compared with intra-arterial administration of contrast after adjustment for heart failure, hypertension, medications, total hydration, iodine load, prior contrast exposure, and all matched variables during the study period. CONCLUSION: Contrast-induced nephropathy after administration of contrast medium is associated with increased mortality. This risk is higher in patients in whom contrast medium is administered intravenously than in those in whom it is administered intraarterially.

UR - http://www.scopus.com/inward/record.url?scp=54049151190&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=54049151190&partnerID=8YFLogxK

U2 - 10.4065/83.10.1095

DO - 10.4065/83.10.1095

M3 - Article

C2 - 18828968

AN - SCOPUS:54049151190

VL - 83

SP - 1095

EP - 1100

JO - Mayo Clinic Proceedings

JF - Mayo Clinic Proceedings

SN - 0025-6196

IS - 10

ER -