Meta-analysis: serum creatinine changes following contrast enhanced CT imaging

Eur J Radiol. 2012 Oct;81(10):2554-61. doi: 10.1016/j.ejrad.2011.11.020. Epub 2011 Dec 15.

Abstract

Purpose: Contrast induced nephropathy (CIN) is defined as a decrease in renal function following administration of contrast media. The aim of this meta-analysis was to asses the overall risk of CIN, chronic loss of kidney function and the need for renal replacement therapy (RRT) after intravenous contrast enhanced CT-scan. Secondly, we aimed to identify subgroups at increased risk for CIN.

Materials and methods: A literature search in Pubmed, Medline, Embase and Cochrane databases was performed. Data extraction was carried out independently by two reviewers. Meta-analysis and meta-regression were performed using an exact likelihood approach.

Results: Forty studies evaluating the incidence of CIN after CT were included. The pooled incidence of CIN was 6.4% (95% CI 5.0-8.1). The risk of RRT after CIN was low, 0.06% (95% CI 0.01-0.4). The decline in renal function persisted in 1.1% of patients (95% CI 0.6-2.1%). Patients with chronic kidney disease (odds ratio 2.26, p<0.001) or diabetes mellitus (odds ratio 3.10, p<0.001) were at increased risk for the development of CIN.

Conclusion: CIN occurred in 6% of patients after contrast enhanced CT. In 1% of all patients undergoing contrast enhanced CT the decline in renal function persisted.

Publication types

  • Meta-Analysis

MeSH terms

  • Biomarkers / blood
  • Contrast Media
  • Creatinine / blood*
  • Drug-Related Side Effects and Adverse Reactions / blood*
  • Drug-Related Side Effects and Adverse Reactions / epidemiology*
  • Humans
  • Prevalence
  • Renal Insufficiency, Chronic / blood*
  • Renal Insufficiency, Chronic / epidemiology*
  • Reproducibility of Results
  • Risk Assessment
  • Sensitivity and Specificity
  • Tomography, X-Ray Computed / statistics & numerical data*

Substances

  • Biomarkers
  • Contrast Media
  • Creatinine