Prevelance and predisposing factors of in hospital-contrast induced nephropathy due to contrast-enhanced ct applications in emergency department

AIMThe aim of this study is to determine the frequency of contrast induced nephropathy (CIN) development and the causes that facilitate the development of CIN in patients admitted to Dokuz Eylul University Hospital Emergency Service and given computed tomography with intravenous contrast media.METHODIn our retrospective, cross-sectional and analytic study patients over 18 years of age; who were admitted to our emergency service, given intravenous contrast and followed in the hospital for longer than 48 hours were identified. The demographic characteristics, clinical and laboratory findings, diagnoses, clinical results of patients and the prophylactic treatments applied to these patients in the emergency service or in the service they were admitted to were evaluated. European Society of Urogenital Radiology guidelines were used to define CIN. All data were recorded to standard data forms prepared for the study, and then to a database program ?Statistical Package for Social Sciences for Windows 15.0?. P value <0,05 was meaningful for statistical analysis.RESULTS2193 patients given intravenous contrast media were identified during the study period. 816 of these patients were included in the study. Nephropathy after administration of contrast was determined in 75 (9.2%) patients. After excluding other causes, contrast induced nephropathy was found in 36 (4.4%) patients and the average hospital stay of these patients was 22.2±41.7 days. % 63.9 of the patients who developed CIN was older than 65 years and there was an increased risk for development of CIN in patients older than 65 years. The presence of Hypertension, Diabetes Mellitus in patients and presence of hypotension during admission to the emergency deparrment and using ACE inhibitors were specified as risk factors for CIN development (for all p<0.05). Hemodialysis was performed in 5.6% (n=2) of patients with CIN. The mortality rate of CIN (when the other causes of death excluded) was determined 2.8%.CONCLUSIONPatients with HT and DM, older than 65 years, using ACE inhibitors and presence of hypotension during admission to the emergency department are at risk for CIN. Despite the lower risk for CIN in the emergency service, CIN may cause patients to stay in hospital for a long time. Patients with CIN have a high mortality rate along with their other diseases.KEYWORDSContrast media, contrast induced nephropathy, emergency department