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Contrast-induced nephropathy in patients with active cancer undergoing contrast-enhanced computed tomography
김윤정 , 안신 , 홍석인 , 이윤선 , 김원영 , 임경수
UCI I410-ECN-0102-2017-510-000091707
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Introduction: This study was performed to measure the incidence and identify potential predictors of contrast-induced nephropathy (CIN) in cancer patients without chronic kidney disease and with normal or near-normal baseline serum creatinine measures who underwent contrast-enhanced computed tomography (CECT). Material & Methods: A retrospective analysis was performed of 820 cancer patients who presented at our emergency department from October 2014 to March 2015. CIN was defined as an increase in creatinine concentration of ≥0.5 mg/dL or ≥25% above baseline that occurred 48 to 72 hours after CECT. Results: The incidence of CIN was 8.0%. Serial CT examination [odds ratio (OR): 4.09, 95% confidence interval (CI): 1.34-12.56], hypotension before the CT scan (OR: 3.95, 95% CI: 1.77-8.83), liver cirrhosis (OR: 2.82, 95% CI: 1.06-7.55), BUN/creatinine >20 (OR: 2.54, 95% CI: 1.44-4.46), and peritoneal carcinomatosis (OR: 1.75, 95% CI: 1.01-3.00) were independently associated with CIN. Of 66 CIN patients, 44 met any of the severity criteria of the RIFLE classification. Conclusion: Even when the baseline serum creatinine is ≤1.5 mg/dL, a significant portion of cancer patients are still at risk of CIN. Consecutive CECT examinations, hypotension before CT, liver cirrhosis, dehydration, and peritoneal carcinomatosis seem to predispose patients to CIN.

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