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ECR 2013 / C-1555
Prevalence of contrast induced nephropaty (CIN) in preemptive living renal donor recipients after enhanced CT with CIN prophylaxis
Congress: ECR 2013
Poster No.: C-1555
Type: Scientific Exhibit
Keywords: Kidney, Contrast agents, CT, Contrast agent-intravenous, Transplantation
Authors: J. M. Gutiérrez, M. C. Sebastia, B. Miquel, L. Buñesch, L. Peri, C. Nicolau; Barcelona/ES
DOI:10.1594/ecr2013/C-1555

Results

The male:female ratio was 3.2:1, with a mean age of 53 years (R: 32-77). 

 

Patients were followed up until transplantation. The mean follow-up was 80 days (R: 8-369).

 

The average creatinine level 15 days before, immediately before, 2 days after and 15 days after the angioCT scan were 4.43 (R:1.76-6,31), 4.6 (R: 2.07-6.64), 4.6 (R: 2.36-6.8) and 4.9 (R: 2.1-7.5), respectively. There were not significant differences between the levels of creatinine immediately before the CT and 2 days after the CT (0.300) (graph 1).

 

Fig. 3: Graph 1. Differences between creatinine levels immediately before the test and 48 hrs after the angio-CT scan. Statistical analysis for related samples (Wilcoxon) showed no significant differences.
References: Radiologia, Hospital Clinic - Barcelona/ES

 

 

Only two (9.5%) patients presented with an increase in creatinine levels > 0.5mg/dl 2 days after the angio-CT. However, no worsening in renal function was observed in these patients. In both cases, a significant decrease in creatinine levels occurred after 15 days. Table 2 shows variations in the creatinine levels in these patients.

 

Fig. 4: Table 2 shows the changes in creatinine levels in the two patients who fulfilled the diagnostic criteria for CIN
References: Radiologia, Hospital Clinic - Barcelona/ES

 

Although there was a significant increase in average creatinine levels between the measurement done immediately before and 14 days after the angio-CT (0.007), this difference was not significant if we compare it with the increase observed between creatinine levels measured 15 days before and immediately before the angio-CT (0.6). The increase observed after 15 days could be therefore attributed to the progression of disease itself. There is, however, some degree of bias due to the small sample size. Graph 2 shows the results of the statistical analysis.

 

Fig. 5: Graph 2. Differences between creatinine levels 14 days before, immediately before and 14 days after the angio-CT. Statistical analysis for related samples (Wilcoxon) showed no significant differences.
References: Radiologia, Hospital Clinic - Barcelona/ES

 

Only one patient started dialysis (37 days after the angio-CT) due to the impossibility of performing the living-donor transplantation. The patient did not develop CIN, showing an increase of 0.3 mg/dl (from 4.9 to 5.2 mg/dl) in his creatinine levels in the first 48 hrs.

 

Nineteen patients were transplanted during follow-up. The mean time between angio-CT and kidney transplantation was 49 days.

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