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首页> 外文期刊>AJR: American Journal of Roentgenology : Including Diagnostic Radiology, Radiation Oncology, Nuclear Medicine, Ultrasonography and Related Basic Sciences >Background fluctuation of kidney function versus contrast-induced nephrotoxicity.
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Background fluctuation of kidney function versus contrast-induced nephrotoxicity.

机译：肾脏功能的背景波动与对比剂引起的肾毒性。

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OBJECTIVE: The reported incidence of contrast-induced acute kidney injury varies widely. Almost no studies have been conducted to quantify the background fluctuation of kidney function of patients receiving iodinated contrast medium. The purpose of this study was a retrospective comparison of the incidence of acute kidney injury among patients undergoing CT with low-osmolar (iohexol) or isoosmolar (iodixanol) contrast medium with the incidence among patients undergoing CT without contrast administration. MATERIALS AND METHODS: Creatinine concentration and estimated glomerular filtration rate were evaluated for 11,588 patients. Rates of acute kidney injury (defined as a 0.5 mg/dL increase in serum creatinine concentration or a 25% or greater decrease in estimated glomerular filtration rate within 3 days after CT) were compared among groups and stratified according to creatinine concentration and estimated glomerular filtration rate before the imaging examination. RESULTS: In all groups, the incidence of acute kidney injury increased with increasing baseline creatinine concentration. No significant difference in incidence of presumed contrast-induced kidney injury was identified between the isoosmolar contrast medium and the control groups. The incidence of acute kidney injury in the low-osmolar contrast medium cohort paralleled that of the control cohort up to a creatinine level of 1.8 mg/dL, but increases above this level were associated with a higher incidence of acute kidney injury. CONCLUSION: We identified a high incidence of acute kidney injury among control subjects undergoing unenhanced CT. The incidence of creatinine elevation in this group was statistically similar to that in the isoosmolar contrast medium group for all baseline creatinine values and all stages of chronic kidney disease. These findings suggest that the additional risk of acute kidney injury accompanying administration of contrast medium (contrast-induced nephrotoxicity) may be overstated and that much of the creatinine elevation in these patients is attributable to background fluctuation, underlying disease, or treatment.
机译：目的：报道的对比剂诱发的急性肾损伤的发生率差异很大。几乎没有进行量化碘化造影剂患者肾脏功能背景波动的研究。这项研究的目的是回顾性比较低渗（碘己醇）或等渗（碘克沙醇）造影剂接受CT的患者与未接受造影剂接受CT的患者之间的急性肾损伤发生率。材料与方法：评价了11588例患者的肌酐浓度和估计的肾小球滤过率。在各组之间比较急性肾损伤的发生率（定义为CT后3天内血清肌酐浓度增加0.5 mg / dL或估计的肾小球滤过率降低25％或更大），并根据肌酐浓度和估计的肾小球滤过进行分层影像检查之前的比率。结果：在所有组中，急性肾损伤的发生率随基线肌酐浓度的升高而增加。在等渗性造影剂和对照组之间，没有发现假定的造影剂诱发的肾损伤发生率的显着差异。低渗透性造影剂队列中的急性肾损伤发生率与对照队列中的肌酐水平达到1.8 mg / dL相当，但高于该水平则与急性肾损伤的发生率较高相关。结论：我们发现接受未增强CT的对照组受试者中急性肾损伤的发生率很高。在所有基线肌酐值和所有慢性肾脏疾病阶段，该组肌酐升高的发生率在统计学上均与等渗造影剂组相似。这些发现表明，可能会高估伴随使用造影剂（造影剂引起的肾毒性）而引起的急性肾损伤的额外风险，并且这些患者中的肌酐升高大部分归因于背景波动，潜在疾病或治疗。

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