Determination of risk factors associated with contrast induced nephropathy

Introduction and Purpose: Contrast induced nephropathy is one of the main reasons of morbidity and mortality in hospitalized patients. Increased awareness about facilitating factors bring on contrast induced nephropathy is essential not only to detect patients under increased risk but also to establish early treatment. The goal of this study was to determine risk factors regarding contrast induced nephropathy and to identify high-risk subgroups. Material and Method: This was a retrospective study of all patients admitted during one year period for a CT scan in emergency department at Akdeniz University. All patients above 18 years old who underwent initial diagnostic management using IV contrast medium for CT scan of brain were included in this study. For all patients we recorded; age, gender, inital and subsequent serum creatinine levels, the type and dose of contrast medium, and concomitant medical comorbidities, including diabetes, hypertension, renal insufficiency, congestive heart disease and multipl myelom. Contrast induced nephropathy defined as an increase in serum creatinine greater than 25% or ≥ 0.5 mg/dl within three days of IV contrast administration in the absence of an alternative cause. Findings: 350 patients were included to the study. The median age of patients was 58±17,7. The incidence of contrast induced nephropathy was 14% (49 patients). The multivariate analysis using binary logistic regression found that older age is independently associated with increased risk for developing contrast induced nephropathy (p=0,006). Conclusion: Increased age is the only independent risk factor associated with contrast induced nephropathy. Patients who have more than one risk factors concomitantly are also considered in high risk subgroup. Key words: Contrast medium, contrast induced nephropathy, emergency department.