Contrast nephropathy following computed tomography angiography of the chest for pulmonary embolism in the emergency department

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Abstract

Objective: To estimate the frequency of contrast nephropathy after computed tomography angiography (CTA) to rule out pulmonary embolism (PE) in the emergency department (ED) setting. Methods: We prospectively followed patients undergoing CTA for PE, while in the ED, for 45 days. Patients who refused follow-up or were receiving hemodialysis were excluded. Severe renal failure was defined as an increase in creatinine ≥ 3.0 mg dL-1 or a need for hemodialysis within the follow-up period. Patients were also followed for laboratory-defined contrast nephropathy, defined as an increase in creatinine of > 0.5 mg dL-1 or > 25%, within seven days following CTA. Results: A total of 1224 patients were followed, and 354[29%, 95% confidence interval (CI): 26-32%] patients had paired (preCTA and post-CTA) creatinine measurements. None developed renal failure (0/1224; 0%, CI: 0-0.3%). 44 patients developed laboratory-defined contrast nephropathy, corresponding to an overall frequency of 4% (44/1224; CI: 3-5%) and 12% (44/354; 95% CI: 9-16%) among those with paired creatinine measurements. Conclusions: Following CTA for PE, the incidence of severe renal failure was very low, but the incidence of laboratory-defined contrast nephropathy (4% overall and 12% of those with paired measurements) was higher than expected.

Original languageEnglish (US)
Pages (from-to)50-54
Number of pages5
JournalJournal of Thrombosis and Haemostasis
Volume5
Issue number1
DOIs
StatePublished - Jan 2007
Externally publishedYes

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Pulmonary Embolism
Hospital Emergency Service
Thorax
Creatinine
Confidence Intervals
Renal Insufficiency
Renal Dialysis
Incidence
Computed Tomography Angiography

Keywords

  • Computed tomography
  • Contrast media
  • Creatinine
  • Pulmonary embolism
  • Renal failure

ASJC Scopus subject areas

  • Medicine(all)

Cite this

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title = "Contrast nephropathy following computed tomography angiography of the chest for pulmonary embolism in the emergency department",
abstract = "Objective: To estimate the frequency of contrast nephropathy after computed tomography angiography (CTA) to rule out pulmonary embolism (PE) in the emergency department (ED) setting. Methods: We prospectively followed patients undergoing CTA for PE, while in the ED, for 45 days. Patients who refused follow-up or were receiving hemodialysis were excluded. Severe renal failure was defined as an increase in creatinine ≥ 3.0 mg dL-1 or a need for hemodialysis within the follow-up period. Patients were also followed for laboratory-defined contrast nephropathy, defined as an increase in creatinine of > 0.5 mg dL-1 or > 25{\%}, within seven days following CTA. Results: A total of 1224 patients were followed, and 354[29{\%}, 95{\%} confidence interval (CI): 26-32{\%}] patients had paired (preCTA and post-CTA) creatinine measurements. None developed renal failure (0/1224; 0{\%}, CI: 0-0.3{\%}). 44 patients developed laboratory-defined contrast nephropathy, corresponding to an overall frequency of 4{\%} (44/1224; CI: 3-5{\%}) and 12{\%} (44/354; 95{\%} CI: 9-16{\%}) among those with paired creatinine measurements. Conclusions: Following CTA for PE, the incidence of severe renal failure was very low, but the incidence of laboratory-defined contrast nephropathy (4{\%} overall and 12{\%} of those with paired measurements) was higher than expected.",
keywords = "Computed tomography, Contrast media, Creatinine, Pulmonary embolism, Renal failure",
author = "Alice Mitchell and Jeffrey Kline",
year = "2007",
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T1 - Contrast nephropathy following computed tomography angiography of the chest for pulmonary embolism in the emergency department

AU - Mitchell, Alice

AU - Kline, Jeffrey

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N2 - Objective: To estimate the frequency of contrast nephropathy after computed tomography angiography (CTA) to rule out pulmonary embolism (PE) in the emergency department (ED) setting. Methods: We prospectively followed patients undergoing CTA for PE, while in the ED, for 45 days. Patients who refused follow-up or were receiving hemodialysis were excluded. Severe renal failure was defined as an increase in creatinine ≥ 3.0 mg dL-1 or a need for hemodialysis within the follow-up period. Patients were also followed for laboratory-defined contrast nephropathy, defined as an increase in creatinine of > 0.5 mg dL-1 or > 25%, within seven days following CTA. Results: A total of 1224 patients were followed, and 354[29%, 95% confidence interval (CI): 26-32%] patients had paired (preCTA and post-CTA) creatinine measurements. None developed renal failure (0/1224; 0%, CI: 0-0.3%). 44 patients developed laboratory-defined contrast nephropathy, corresponding to an overall frequency of 4% (44/1224; CI: 3-5%) and 12% (44/354; 95% CI: 9-16%) among those with paired creatinine measurements. Conclusions: Following CTA for PE, the incidence of severe renal failure was very low, but the incidence of laboratory-defined contrast nephropathy (4% overall and 12% of those with paired measurements) was higher than expected.

AB - Objective: To estimate the frequency of contrast nephropathy after computed tomography angiography (CTA) to rule out pulmonary embolism (PE) in the emergency department (ED) setting. Methods: We prospectively followed patients undergoing CTA for PE, while in the ED, for 45 days. Patients who refused follow-up or were receiving hemodialysis were excluded. Severe renal failure was defined as an increase in creatinine ≥ 3.0 mg dL-1 or a need for hemodialysis within the follow-up period. Patients were also followed for laboratory-defined contrast nephropathy, defined as an increase in creatinine of > 0.5 mg dL-1 or > 25%, within seven days following CTA. Results: A total of 1224 patients were followed, and 354[29%, 95% confidence interval (CI): 26-32%] patients had paired (preCTA and post-CTA) creatinine measurements. None developed renal failure (0/1224; 0%, CI: 0-0.3%). 44 patients developed laboratory-defined contrast nephropathy, corresponding to an overall frequency of 4% (44/1224; CI: 3-5%) and 12% (44/354; 95% CI: 9-16%) among those with paired creatinine measurements. Conclusions: Following CTA for PE, the incidence of severe renal failure was very low, but the incidence of laboratory-defined contrast nephropathy (4% overall and 12% of those with paired measurements) was higher than expected.

KW - Computed tomography

KW - Contrast media

KW - Creatinine

KW - Pulmonary embolism

KW - Renal failure

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