Acute Kidney Injury After Computed Tomography: A Meta-analysis
| Autor: | Jennifer L. Boxen, Nima Majlesi, Raveendhara R. Bannuru, Lauren M. Westafer, Ryan D. Aycock, Elizabeth M. Schoenfeld |
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| Rok vydání: | 2018 |
| Předmět: |
medicine.medical_specialty
medicine.medical_treatment MEDLINE Contrast Media Cochrane Library 030218 nuclear medicine & medical imaging 03 medical and health sciences 0302 clinical medicine Risk Factors Outcome Assessment Health Care Odds Ratio medicine Humans Renal replacement therapy business.industry Acute kidney injury Odds ratio Acute Kidney Injury medicine.disease Confidence interval Renal Replacement Therapy Meta-analysis Emergency Medicine Administration Intravenous Observational study Radiology Tomography X-Ray Computed business 030217 neurology & neurosurgery |
| Zdroj: | Annals of Emergency Medicine. 71:44-53.e4 |
| ISSN: | 0196-0644 |
| DOI: | 10.1016/j.annemergmed.2017.06.041 |
| Popis: | Study objective Computed tomography (CT) is an important imaging modality used in the diagnosis of a variety of disorders. Imaging quality may be improved if intravenous contrast is added, but there is a concern for potential renal injury. Our goal is to perform a meta-analysis to compare the risk of acute kidney injury, need for renal replacement, and total mortality after contrast-enhanced CT versus noncontrast CT. Methods We searched MEDLINE (PubMed), the Cochrane Library, CINAHL, Web of Science, ProQuest, and Academic Search Premier for relevant articles. Included articles specifically compared rates of renal insufficiency, need for renal replacement therapy, or mortality in patients who received intravenous contrast versus those who received no contrast. Results The database search returned 14,691 articles, inclusive of duplicates. Twenty-six unique articles met our inclusion criteria, with an additional 2 articles found through hand searching. In total, 28 studies involving 107,335 participants were included in the final analysis, all of which were observational. Meta-analysis demonstrated that, compared with noncontrast CT, contrast-enhanced CT was not significantly associated with either acute kidney injury (odds ratio [OR] 0.94; 95% confidence interval [CI] 0.83 to 1.07), need for renal replacement therapy (OR 0.83; 95% CI 0.59 to 1.16), or all-cause mortality (OR 1.0; 95% CI 0.73 to 1.36). Conclusion We found no significant differences in our principal study outcomes between patients receiving contrast-enhanced CT versus those receiving noncontrast CT. Given similar frequencies of acute kidney injury in patients receiving noncontrast CT, other patient- and illness-level factors, rather than the use of contrast material, likely contribute to the development of acute kidney injury. |
| Databáze: | OpenAIRE |
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