Patients undergoing or about to undergo general surgical procedures can have better CT scan quality from intravenous contrast material with no increased risk for acute kidney injury, according to study results published in Nephrology Dialysis Transplantation.
While the data showed that older men with lower baseline renal function receiving treatment with angiotensin-converting enzyme inhibitors or angiotensin receptor blockers did have a higher risk for AKI post-op, the timing of the contrast material exposure did not increase their risk.
“We thought it was an important clinical issue and something that we've come across in practice, where a patient needs a CT scan with contrast medium,” Samira Bell, MD, Honorary Senior Clinical Lecturer and Consultant Nephrologist at the University of Dundee in the U.K., said in an interview. “[They] don't get a good quality scan because of the theoretical risk of the contrast. So, we wanted to actually do the work to see if this is true and whether there's a risk and doing these contrast scans.”
Researchers analyzed the data of 9,300 patients aged 18 years or older who received diagnostic imaging within 7 days of receiving non-cardiac surgery between Jan. 1, 2003 and Dec. 31, 2013. Overall, 6,224 individuals were exposed to contrast material and 678 (10.9%) patients developed post-op AKI.
“We found that toning didn't influence the risk of acute kidney injury in patients undergoing surgery. From this we concluded that there is no need to scanning or limit the quantity of CT scanning by not giving contrast in these scans for patients who have just recently undergone surgery,” Bell said. “We did find that the older patients that have chronic kidney disease were more likely to get a kidney injury and noted that they were on ACE inhibitors or angiotensin receptor blockers.”
Bell and her colleagues found that, regardless of a patient’s baseline renal function, using contrast-enhanced CT scans does not increase their risk for post-op AKI.
Bell admits that while their results were definitive enough to warrant change in clinical practice, more research is necessary.
“We were hoping to do a randomized control trial of intravenous contrast in patients with chronic kidney disease. That's something that's in the very early stages of development,” Bell said. - by Scott Buzby
Disclosures: Bell reports no relevant financial disclosures. Please see the full study for all other authors’ relevant financial disclosures.
For more information: Bell can be reached at firstname.lastname@example.org