Effect of IV Contrast Medium on Renal Function in Patients with Severe Acute Pancreatitis Undergoing Contrast-Enhanced CT in ICU

Abstract Background Kidney disease and renal failure are associated with hospital deaths in patients with COVID − 19. We aimed to test if contrast enhancement affects short-term renal function in hospitalized COVID − 19 patients. Methods Plasma creatinine (P-creatinine) was measured on the day of computed tomography (CT) and 24 h, 48 h, and 4–10 days after CT. Contrast-enhanced (n = 142) and unenhanced (n = 24) groups were subdivided, based on estimated glomerular filtration rates (eGFR), > 60 and ≤ 60 ml/min/1.73 m2. Contrast-induced acute renal failure (CI-AKI) was defined as ≥27 μmol/L increase or a > 50% rise in P-creatinine from CT or initiation of renal replacement therapy during follow-up. Patients with renal replacement therapy were studied separately. We evaluated factors associated with a > 50% rise in P-creatinine at 48 h and at 4–10 days after contrast-enhanced CT. Results Median P-creatinine at 24–48 h and days 4–10 post-CT in patients with eGFR> 60 and eGFR≥30–60 in contrast-enhanced and unenhanced groups did not differ from basal values. CI-AKI was observed at 48 h and at 4–10 days post contrast administration in 24 and 36% (n = 5/14) of patients with eGFR≥30–60. Corresponding figures in the eGFR> 60 contrast-enhanced CT group were 5 and 5% respectively, (p < 0.037 and p < 0.001, Pearson χ2 test). In the former group, four of the five patients died within 30 days. Odds ratio analysis showed that an eGFR≥30–60 and 30-day mortality were associated with CK-AKI both at 48 h and 4–10 days after contrast-enhanced CT. Conclusion Patients with COVID − 19 and eGFR≥30–60 had a high frequency of CK-AKI at 48 h and at 4–10 days after contrast administration, which was associated with increased 30-day mortality. For patients with eGFR≥30–60, we recommend strict indications are practiced for contrast-enhanced CT. Contrast-enhanced CT had a modest effect in patients with eGFR> 60.

Download Full-text

Diagnostic imaging characteristics of ureteral pseudodiverticulosis in three dogs

Veterinární Medicína ◽

10.17221/26/2018-vetmed ◽

2018 ◽

Vol 63 (No. 8) ◽

pp. 373-378

Author(s):

S. Lim ◽

S. Sung ◽

K. Min ◽

Y. Cho ◽

Y. Jung ◽

...

Keyword(s):

Contrast Medium ◽

Excretory Urography ◽

Inclusion Criteria ◽

Radiographic Findings ◽

Computed Tomographic ◽

Imaging Characteristics ◽

Contrast Enhanced Ct ◽

Contrast Enhanced ◽

Enhanced Ct

Ureteral pseudodiverticulosis is rarely reported in veterinary medicine. This case study aimed to describe the radiographic, ultrasonographic and computed tomographic findings for dogs with radiologically confirmed ureteral pseudodiverticulosis. Three dogs met the inclusion criteria. Radiographic findings included multiple small, round-shaped mineral opacities located around the periphery of the ureters (3/3), and multiple contrast medium-filled outpouchings that appeared and disappeared when the contrast medium washed in and out on intravenous excretory urography (2/3). The outpouchings were approximately 1 mm in diameter. In the ultrasonographic images, the mineral foci were located adjacent to the ureter, but not within the ureteral lumen (1/3). Contrast-enhanced CT findings were similar to those of excretory urography (2/3). Ureteral pseudodiverticulosis should be considered in the differential diagnosis for old-aged and small-breed dogs with radiopaque materials along the ureteral pathways; excretory urography or contrast-enhanced CT are recommended for a more definitive imaging diagnosis.

Download Full-text