Abstract
Aim: Albuminuria is a direct consequence of renal glomerular injury and increases with glomerular dysfunction. Spot urine albumin/creatinine (Alb/Cr) ratio is a reasonable surrogate for 24-hour urine albumin excretion rate and certainly not without limitations. It is known that renal function can be affected following contrast agent administration. The aim of our study is to assess the changes in Alb/Cr ratio in spot urine before and after contrast agents in patients undergoing computed tomography (CT) scanning.
Material and Method: The present study included 103 hospitalized patients aged between 18 and 75 years, who underwent contrast-enhanced CT scanning for any reason and did not develop contrast-induced nephropathy (CIN). We compared the values of Alb/Cr ratio at the 6th, 12th, 24th, 48th, and 72nd hours after the procedure (post-procedure time) with the values at pre-procedure time.
Results: The median age of the patients were 61 years. It has been observed that there is no significant increased in microalbuminuria after the use of contrast media. When the patients were evaluated for the albuminuria level before the procedure, it has been seen that 73 patients (70.9%) had an Alb/Cr ratio of <30 mg/g (group-1) and 30 patients (29.1%) had an Alb/Cr ratio of ≥30 mg/g (group-2). In group 1, it has been observed that the Alb/Cr ratios at the post-procedure 6th, 12th, 24th, and 48th hours were statistically significantly higher than the value at pre-procedure time. In group 2, it has been observed that Alb/Cr ratio values at all post-procedure time except the 24th hour were statistically significantly lower than the values at the pre-procedure time.
Conclusion: It should be considered that there might be changes in Alb/Cr ratio even without developing significant complications such as CIN in patients exposed to contrast medium.
References
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- Deek H, Newton P, Sheerin N, Noureddine S, Davidson PM. Contrast media induced nephropathy: a literature review of the available evidence and recommendations for practice. Aus Crit Care 2014; 27: 166-71.
- Stacul F, van der Molen AJ, Reimer P, et al. Contrast induced nephropathy: updated ESUR Contrast Media Safety Committee guidelines. Eur Radiol 2011; 21: 2527-41.
- Katsiki N, Athyros VG, Karagiannis A, Mikhailidis DP. Contrast-Induced Nephropathy: An "All or None" Phenomenon? Angiology 2015; 66: 508-13.
- Karadeniz M, Kandemir H, Sarak T, Alp Ç. Akut koroner sendromda perkütan koroner girişim yapılan hastalarda kontrast nefropati prevalansı. J Health Sci Med 2018; 1: 34-9.
- Ronco F, Tarantini G, McCullough PA. Contrast induced acute kidney injury in interventional cardiology: an update and key guidance for clinicians. Rev Cardiovasc Med 2020; 2: 9-23.
- Okoye O, Ikubor J, Okosun RE. Biochemical changes associated with intravenous use of contrast media. Tropical J Nephrol 2015; 10: 73-8.
- Seeliger E, Persson PB. Kidney damage by iodinated contrast media. Acta Physiol (Oxf.) 2019; 227: e13259.
- Lippi G, Daves M, Mattiuzzi C. Interference of medical contrast media on laboratory testing. Biochemia Medica 2014; 24: 80-8.
- Keane WF, Eknoyan G. Proteinuria, albuminuria, risk, assessment, detection, elimination (PARADE): a position paper of the National Kidney Foundation. Am J Kidney Dis 1999; 33: 1004-10.
- Thorp ML. Diabetic nephropathy: common questions. Am Fam Physician 2005; 72: 96-9.
- Simerville JA, Maxted WC, Pahira JJ. Urinalysis: a comprehensive review. Am Fam Physician 2005; 71: 1153-62.
- Levin A, Pate GE, Shalansky S, et al. N-acetylcysteine reduces urinary albumin excretion following contrast administration: evidence of biological effect. Nephrol Dial Transplant 2007; 22: 2520-4.
- Nicot GS, Merle LJ, Charmes JP, et al. Transient glomerular proteinuria, enzymuria, and nephrotoxic reaction induced by radiocontrast media. Jama 1984; 252: 2432-4.
- Tumlin JA, Wang A, Murray PT, Mathur VS. Fenoldopam mesylate blocks reductions in renal plasma flow after radiocontrast dye infusion: a pilot trial in the prevention of contrast nephropathy. Am Heart J 2002; 143: 894-903.
- Inker LA, Astor BC, Fox CH, et al. KDOQI US commentary on the 2012 KDIGO clinical practice guideline for the evaluation and management of CKD. Am J Kidney Dis 2014; 63: 713-35.
- Bachorzewska-Gajewska H, Malyszko J, Sitniewska E, Malyszko JS, Dobrzycki S. Neutrophil gelatinase-associated lipocalin (NGAL) correlations with cystatin C, serum creatinine and eGFR in patients with normal serum creatinine undergoing coronary angiography. Nephrol Dial Transplant 2007; 22: 295-6.
- Chu CS, Cheng KH, Lee KT, et al. Negligible effect of non-ionic radiocontrast medium exposure on microalbuminuria in patients undergoing coronary angiography. Int J Cardiol 2009; 132: 150-1.
- Holtås S, Billström A, Tejler L. Proteinuria following nephroangiography. IX. Chemical and morphological analysis in dogs. Acta Radiol Diagn 1981; 22: 427-33.
- Holtås S, Golman K, Törnquist C. Proteinuria following nephroangiography. VIII. Comparison between diatrizoate and iohexol in the rat. Acta Radiol Suppl 1980; 362: 53-5.
- Hogg RJ, Furth S, Lemley KV, et al. National Kidney Foundation's Kidney Disease Outcomes Quality Initiative clinical practice guidelines for chronic kidney disease in children and adolescents: evaluation, classification, and stratification. Pediatrics 2003; 111: 1416-21.
- Thomsen HS, Morcos SK. Radiographic contrast media. BJU Int 2000; 86: 1-10.
Abstract
References
- Andreucci M, Faga T, Pisani A, Sabbatini M, Russo D, Michael A. Prevention of contrast-induced nephropathy through a knowledge of its pathogenesis and risk factors. ScientificWorldJournal 2014; 2014: 823169.
- Deek H, Newton P, Sheerin N, Noureddine S, Davidson PM. Contrast media induced nephropathy: a literature review of the available evidence and recommendations for practice. Aus Crit Care 2014; 27: 166-71.
- Stacul F, van der Molen AJ, Reimer P, et al. Contrast induced nephropathy: updated ESUR Contrast Media Safety Committee guidelines. Eur Radiol 2011; 21: 2527-41.
- Katsiki N, Athyros VG, Karagiannis A, Mikhailidis DP. Contrast-Induced Nephropathy: An "All or None" Phenomenon? Angiology 2015; 66: 508-13.
- Karadeniz M, Kandemir H, Sarak T, Alp Ç. Akut koroner sendromda perkütan koroner girişim yapılan hastalarda kontrast nefropati prevalansı. J Health Sci Med 2018; 1: 34-9.
- Ronco F, Tarantini G, McCullough PA. Contrast induced acute kidney injury in interventional cardiology: an update and key guidance for clinicians. Rev Cardiovasc Med 2020; 2: 9-23.
- Okoye O, Ikubor J, Okosun RE. Biochemical changes associated with intravenous use of contrast media. Tropical J Nephrol 2015; 10: 73-8.
- Seeliger E, Persson PB. Kidney damage by iodinated contrast media. Acta Physiol (Oxf.) 2019; 227: e13259.
- Lippi G, Daves M, Mattiuzzi C. Interference of medical contrast media on laboratory testing. Biochemia Medica 2014; 24: 80-8.
- Keane WF, Eknoyan G. Proteinuria, albuminuria, risk, assessment, detection, elimination (PARADE): a position paper of the National Kidney Foundation. Am J Kidney Dis 1999; 33: 1004-10.
- Thorp ML. Diabetic nephropathy: common questions. Am Fam Physician 2005; 72: 96-9.
- Simerville JA, Maxted WC, Pahira JJ. Urinalysis: a comprehensive review. Am Fam Physician 2005; 71: 1153-62.
- Levin A, Pate GE, Shalansky S, et al. N-acetylcysteine reduces urinary albumin excretion following contrast administration: evidence of biological effect. Nephrol Dial Transplant 2007; 22: 2520-4.
- Nicot GS, Merle LJ, Charmes JP, et al. Transient glomerular proteinuria, enzymuria, and nephrotoxic reaction induced by radiocontrast media. Jama 1984; 252: 2432-4.
- Tumlin JA, Wang A, Murray PT, Mathur VS. Fenoldopam mesylate blocks reductions in renal plasma flow after radiocontrast dye infusion: a pilot trial in the prevention of contrast nephropathy. Am Heart J 2002; 143: 894-903.
- Inker LA, Astor BC, Fox CH, et al. KDOQI US commentary on the 2012 KDIGO clinical practice guideline for the evaluation and management of CKD. Am J Kidney Dis 2014; 63: 713-35.
- Bachorzewska-Gajewska H, Malyszko J, Sitniewska E, Malyszko JS, Dobrzycki S. Neutrophil gelatinase-associated lipocalin (NGAL) correlations with cystatin C, serum creatinine and eGFR in patients with normal serum creatinine undergoing coronary angiography. Nephrol Dial Transplant 2007; 22: 295-6.
- Chu CS, Cheng KH, Lee KT, et al. Negligible effect of non-ionic radiocontrast medium exposure on microalbuminuria in patients undergoing coronary angiography. Int J Cardiol 2009; 132: 150-1.
- Holtås S, Billström A, Tejler L. Proteinuria following nephroangiography. IX. Chemical and morphological analysis in dogs. Acta Radiol Diagn 1981; 22: 427-33.
- Holtås S, Golman K, Törnquist C. Proteinuria following nephroangiography. VIII. Comparison between diatrizoate and iohexol in the rat. Acta Radiol Suppl 1980; 362: 53-5.
- Hogg RJ, Furth S, Lemley KV, et al. National Kidney Foundation's Kidney Disease Outcomes Quality Initiative clinical practice guidelines for chronic kidney disease in children and adolescents: evaluation, classification, and stratification. Pediatrics 2003; 111: 1416-21.
- Thomsen HS, Morcos SK. Radiographic contrast media. BJU Int 2000; 86: 1-10.
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| Primary Language | English |
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| Subjects | Health Care Administration |
| Journal Section | Original Article |
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| Publication Date | January 17, 2022 |
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