News | Contrast Media | January 30, 2017

IV Contrast for CT Not Associated with Increased Risk of Acute Kidney Injury

Controlled study finds injury risk is actually higher for patients receiving unenhanced CT or not receiving CT at all

CT, computed tomography, IV contrast media, acute kidney injury risk, Annals of Emergency Medicine study

A new study in Annals of Emergency Medicine finds no association between intravenous contrast media used in computed tomography (CT) and kidney damage. Roughly 80 million doses of IV contrast media are given every year. Credit: American College of Emergency Physicians

January 30, 2017 — Intravenous contrast media (typically iohexol or iodixanol) used in computed tomography (CT) does not appear to be associated with chronic kidney disease, dialysis, kidney transplant or acute kidney injury, despite long-held fears to the contrary. The results of the largest controlled study of acute kidney injury following contrast media administration in the emergency department were published online in Annals of Emergency Medicine ("Risk of Acute Kidney Injury Following Intravenous Contrast Media Administration").

"Over 80 million doses of IV contrast media are administered every year, and in the emergency department it can be essential to accurately diagnose certain acute critical conditions," said lead study author Jeremiah Hinson, M.D., Ph.D., of Johns Hopkins University School of Medicine in Baltimore. "But physicians have had concerns that the contrast media causes serious kidney problems later on, with some studies showing contrast-induced nephropathy occurring in as many as 14 percent of patients receiving it. However, studies used to establish this risk were performed prior to the development of modern contrast reagents or without adequate controls. Using a controlled design in current context, we could not find an association between intravenous contrast media use and acute kidney injury."

Researchers studied five years of records for patients receiving CT with or without contrast-enhancement in the emergency department. Of all CT scans, 57.2 percent were contrast-enhanced. The probability of developing acute kidney injury was 6.8 percent for patients undergoing contrast-enhanced CT, 8.9 percent for patients receiving unenhanced CT and 8.1 percent for patients not receiving CT at all.

"While a well-controlled randomized prospective study is required to fully determine the contribution of intravenous contrast media to the development of acute kidney injury, our results clearly demonstrate that in emergency departments such as ours where practice patterns have evolved to protect patients' kidneys, contrast media is not associated with increased risk of kidney injury," said Hinson. "Our data also suggest that in cases where contrast-enhanced CT is indicated to avoid delayed or missed diagnosis of critical disease, the potential morbidity and mortality resulting from a failure to diagnose potentially life-threatening conditions likely outweigh any potential risk of kidney injury.”

For more information: www.annemergmed.com

Hinson, J.S., Ehmann, M.R., Fine, D.M., Fishman, E.K., et al. "Risk of Acute Kidney Injury After Intravenous Contrast Media Administration," Annals of Emergency Medicine. Published Jan. 25, 2017. DOI: http://dx.doi.org/10.1016/j.annemergmed.2016.11.021

Related Content

Machine Learning IDs Markers to Help Predict Alzheimer's

Neurologists use structural and diffusion magnetic resonance imaging (MRI) to identify changes in brain tissue (both gray and white matter) that are characteristic of Alzheimer's disease and other forms of dementia. The MRI images are analyzed using morphometry and tractography techniques, which detect changes in the shape and dimensions of the brain and in the tissue microstructure, respectively. In this example, the images show the normal brain of an elderly patient. Image courtesy of Jiook Cha.

News | Neuro Imaging | September 20, 2018
New research has shown a combination of two different modes of magnetic resonance imaging (MRI), computer-based...
SimonMed Deploys ClearRead CT Enterprise Wide
News | Computer-Aided Detection Software | September 17, 2018
September 17, 2018 — National outpatient physician radiology group SimonMed Imaging has selected Riverain Technologie
Siemens Healthineers Announces First U.S. Install of Somatom go.Top CT
News | Computed Tomography (CT) | September 17, 2018
September 17, 2018 — The Ohio State University Wexner Medical Center in Columbus recently became the first healthcare
Gadolinium contrast agents (GBCAs) are partly retained in the brain, raising safety concerns, as seen in this MRI.

Gadolinium contrast agents (GBCAs) are partly retained in the brain, raising safety concerns, as seen in this MRI.

News | Contrast Media | September 12, 2018
In February 2018, a workshop was held at the National Institutes of Health (NIH) in Bethesda, Maryland, to explore co
The CT scanner might not come with protocols that are adequate for each hospital situation, so at Phoenix Children’s Hospital they designed their own protocols, said Dianna Bardo, M.D., director of body MR and co-director of the 3D Innovation Lab at Phoenix Children’s.

The CT scanner might not come with protocols that are adequate for each hospital situation, so at Phoenix Children’s Hospital they designed their own protocols, said Dianna Bardo, M.D., director of body MR and co-director of the 3D Innovation Lab at Phoenix Children’s.

Sponsored Content | Case Study | Radiation Dose Management | September 07, 2018
Radiation dose management is central to child patient safety. Medical imaging plays an increasing role in the accurate...
Carestream Releases Second-Generation Metal Artifact Reduction Software for OnSight 3D Extremity System
Technology | Computed Tomography (CT) | September 06, 2018
Carestream Health has started shipping a new software version for its Carestream OnSight 3D Extremity System that...

Image courtesy of Siemens Healthineers

Feature | CT Angiography (CTA) | September 06, 2018 | Dave Fornell
There have been a few big, recent advancements in cardiac computed tomography angiography (CCTA) imaging technology....
Key Patient Preparations for a CT Scan
News | Computed Tomography (CT) | September 05, 2018
The Center for Diagnostic Imaging (CDI) in Miami recently released a list of important preparations patients should...
PET Imaging Agent Predicts Brain Tau Pathology, Alzheimer's Diagnosis
News | PET Imaging | September 05, 2018
Eli Lilly and Co. and Avid Radiopharmaceuticals Inc. announced a Phase 3 study of positron emission tomography (PET)...
Check-Cap Announces Interim Results of European Study of C-Scan System Version 3
News | Colonoscopy Systems | September 04, 2018
Check-Cap Ltd. announced the interim results for its post-CE approval study of the C-Scan system Version 3, an...