scholarly journals Negative effects of iodine-based contrast agent on renal function in patients with moderate reduced renal function hospitalized for COVID-19

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Anna Kistner ◽  
Chen Tamm ◽  
Ann Mari Svensson ◽  
Mats O. Beckman ◽  
Fredrik Strand ◽  
...  
Keyword(s):  
Renal Failure ◽  
Renal Function ◽  
Renal Replacement Therapy ◽  
Replacement Therapy ◽  
Contrast Administration ◽  
Post Contrast ◽  
Contrast Enhanced Ct ◽  
Contrast Enhanced ◽  
Enhanced Ct ◽  
Ct Contrast

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.

scholarly journals Multi-factorial considerations for intra-thoracic lymph node evaluations of healthy cats on computed tomographic images

2021 ◽  
Vol 17 (1) ◽  
Author(s):  
Ninlawan Thammasiri ◽  
Chutimon Thanaboonnipat ◽  
Nan Choisunirachon ◽  
Damri Darawiroj
Keyword(s):  
Lymph Node ◽  
Lymph Nodes ◽  
Ct Images ◽  
Slice Thickness ◽  
Maximum Width ◽  
Post Contrast ◽  
Computed Tomographic ◽  
Contrast Enhanced Ct ◽  
Contrast Enhanced ◽  
Enhanced Ct

Abstract Background It is difficult to examine mild to moderate feline intra-thoracic lymphadenopathy via and thoracic radiography. Despite previous information from computed tomographic (CT) images of intra-thoracic lymph nodes, some factors from animals and CT setting were less elucidated. Therefore, this study aimed to investigate the effect of internal factors from animals and external factors from the CT procedure on the feasibility to detect the intra-thoracic lymph nodes. Twenty-four, client-owned, clinically healthy cats were categorized into three groups according to age. They underwent pre- and post-contrast enhanced CT for whole thorax followed by inter-group evaluation and comparison of sternal, cranial mediastinal, and tracheobronchial lymph nodes. Results Post contrast-enhanced CT appearances revealed that intra-thoracic lymph nodes of kittens were invisible, whereas the sternal, cranial mediastinal, and tracheobronchial nodes of cats aged over 7 months old were detected (6/24, 9/24 and 7/24, respectively). Maximum width of these lymph nodes were 3.93 ± 0.74 mm, 4.02 ± 0.65 mm, and 3.51 ± 0.62 mm, respectively. By age, lymph node sizes of these cats were not significantly different. Transverse lymph node width of males was larger than that of females (P = 0.0425). Besides, the detection score of lymph nodes was affected by slice thickness (P < 0.01) and lymph node width (P = 0.0049). Furthermore, an irregular, soft tissue structure, possibly the thymus, was detected in all juvenile cats and three mature cats. Conclusions Despite additional information on intra-thoracic lymph nodes in CT images, which can be used to investigate lymphatic-related abnormalities, age, sex, and slice thickness of CT images must be also considered.

Can Texture Analysis Be Used to Distinguish Benign From Malignant Adrenal Nodules on Unenhanced CT, Contrast-Enhanced CT, or In-Phase and Opposed-Phase MRI?

2019 ◽  
Vol 212 (3) ◽  
pp. 554-561 ◽  
Author(s):  
Lisa M. Ho ◽  
Ehsan Samei ◽  
Maciej A. Mazurowski ◽  
Yuese Zheng ◽  
Brian C. Allen ◽  
...  
Keyword(s):  
Texture Analysis ◽  
Unenhanced Ct ◽  
Contrast Enhanced Ct ◽  
Contrast Enhanced ◽  
Enhanced Ct ◽  
Ct Contrast

Dialytic Support in Patients with Acute Renal Failure with Implantable Left Ventricular Assist Devices

1997 ◽  
Vol 12 (1) ◽  
pp. 33-39 ◽  
Author(s):  
Luz Moreno ◽  
Martine Leblanc ◽  
Melisa Gurley ◽  
Patrick Mccarthy ◽  
Emil P. Paganini
Keyword(s):  
Renal Failure ◽  
Renal Function ◽  
Renal Replacement Therapy ◽  
Serum Creatinine ◽  
Heart Transplantation ◽  
Replacement Therapy ◽  
Metabolic Control ◽  
Left Ventricular ◽  
Ventricular Assist ◽  
Left Ventricular Assist

The left ventricular assist device (LVAD), used thus far as a bridge to heart transplantation, may offer an alternative to heart transplantation. Because patients receiving LVADs are in cardiogenic shock, many experience acute ischemic renal failure in the peri-implantation period. We describe 10 patients who underwent dialysis after receiving LVADs for end-stage heart disease. Among 37 patients who received an LVAD, 10 required dialytic support (8 men, 2 women; mean age, 47.3 ± 11.3 yr; mean APACHE II score at ICU admission, 18.0 ± 4.7). Renal replacement therapy was started for fluid removal within 48 hours of LVAD implantation in 8 patients. Continuous renal replacement therapy (CRRT) was the first-line modality for 9 patients, including 3 slow continuous ultrafiltrations (SCUF), 4 continuous venovenous hemofiltrations (CWH), 5 continuous venovenous hemodiafiltrations (CWHD), 2 continuous arteriovenous hemofiltrations (CAVH), and 1 continuous arteriovenous hemodiafiltration (CAVHD). Patients remained on CRRT for a mean of 14.4 ± 6.1 days, and 5 were eventually changed to intermittent hemodialysis. The mean time on renal replacement therapy was 27.8 ± 19.7 days. During CRRT, despite daily average ultrafiltration of 3,445 ± 623 mL, net fluid loss was only 358 ± 507 mL/day. Metabolic control achieved with CRRT, expressed as mean ± SD, was: BUN 75.5 ± 13.0 mg/dL (26.9 ± mmol/L), serum creatinine 4.0 ± 0.7 mg/dL (354 ± 62 mmol/L), carbon dioxide content (bicarbonate plus dissolved CO2) 21.5 ± 1.7 mEq/L, and serum electrolytes within normal limits. Survival for patients with LVADs who did not require dialysis was 93% compared with 40% for the group with combined LVADs and dialytic support. The 4 patients who survived in the dialysis group all recovered renal function, and their need for dialysis ceased within 18 to 33 days. Mean serum creatinine levels at follow-up after transplantation were 2.0 ± 1.0 mg/dL (177 ± 88 mmol/L). In conclusion, CRRT provides good metabolic control and allows large ultrafiltration volume in patients supported by an implantable LVAD. We observed a 40% survival rate in patients with combined LVADS and dialytic support, and the survivors all recovered renal function.

Renal disease

2018 ◽  
Author(s):  
Quentin Milner
Keyword(s):  
Chronic Kidney Disease ◽  
Renal Failure ◽  
Renal Function ◽  
Acute Renal Failure ◽  
Renal Replacement Therapy ◽  
Kidney Disease ◽  
Renal Disease ◽  
Replacement Therapy ◽  
Impaired Renal Function ◽  
Anaesthetic Management

This chapter describes the anaesthetic management of the patient with renal disease. The topics include estimation of renal function, chronic kidney disease, renal replacement therapy (including haemodialysis), acute renal failure, and the patient with a transplanted kidney. For each topic, preoperative investigation and optimization, treatment, and anaesthetic management are described. The effects of impaired renal function on the elimination of anaesthetic drugs are discussed.

Incidental 99mTc MDP uptake in the intestines and intravenous CT contrast

2016 ◽  
Vol 55 (04) ◽  
pp. 166-171 ◽  
Author(s):  
Soo Kim ◽  
Joo Lee ◽  
Seung Hyun ◽  
Young Cho ◽  
Seung Moon ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Bone Scintigraphy ◽  
Bone Scan ◽  
Contrast Injection ◽  
Intestinal Uptake ◽  
Contrast Enhanced Ct ◽  
Contrast Enhanced ◽  
Enhanced Ct ◽  
Bone Scans ◽  
Ct Contrast

SummaryAim: We evaluated the association between intestinal visualization on bone scintigraphy and IV CT contrast in patients with breast cancer. Patients, methods: 452 patients with breast cancer underwent a 99mTc methylene diphosphonate (MDP) bone scan for surveillance of bone metastasis. Presence, site and intensity of intestinal uptake were visually assessed. For patients with intestinal visualization, medical records were reviewed to identify the alleged potential causes. When IV CT contrast was administrated on the same day as bone scan, the time between IV CT contrast injection, 99mTc MDP administration and bone scan was assessed. Results: Intestinal 99mTc MDP uptake was observed in 44 of the 452 patients (9.7%). Bone scans showed no thyroid or gastric uptake that suggested free pertechnetate. There were no patients with documented causes of intestinal uptake except for one patient with vesicoenteric fistula. Of the 452 patients, 149 (33.0%) underwent IV contrast-enhanced CT on the same day as bone scan. Forty of the 44 patients (90.9%) with intestinal uptake on bone scan underwent IV contrast-enhanced CT on the same day, whereas 109 of 408 (26.7%) patients without intestinal uptake on bone scintigraphy underwent IV contrast-enhanced CT on the same day (p < 0.001). The patients who underwent IV contrast injection between Tc-99m MDP administration and acquisition of bone scans had significantly more frequent intestinal uptake than patients who underwent IV contrast injection either before 99mTc MDP administration or after bone scanning (42.4% vs. 1.8%, p < 0.001). Conclusions: IV CT contrast injection administered on the same day as bone scintigraphy is significantly associated with 99mTc MDP uptake in the intestines among patients with breast cancer.

Strategies for Treatment and Prevention of Acute Renal Failure

2002 ◽  
Vol 15 (5) ◽  
pp. 392-404
Author(s):  
Mary K. Stamatakis
Keyword(s):  
Renal Failure ◽  
Renal Function ◽  
Acute Renal Failure ◽  
Renal Replacement Therapy ◽  
Replacement Therapy ◽  
Medical Condition ◽  
Extracellular Fluid ◽  
Pharmacologic Therapy ◽  
Treatment And Prevention ◽  
Life Threatening

Acute renal failure (ARF) is a potentially life-threatening medical condition that often complicates the hospitalization of critically ill patients. A variety of therapeutic strategies has been studied for both preventing ischemic and nephrotoxic injury to the kidney and improving renal function in established ARF. This article summarizes the role of pharmacologic therapy in the treatment of ARF. Strategies to reduce extracellular fluid volume and preserve renal function with loop diuretics, low-dose dopamine, and renal replacement therapy will be discussed. The value of preventative therapy has increased, and identifying patients at high risk for development of ARF is critical. Modification of drug regimens, administration of less nephrotoxic medications, and volume expansion prior to nephrotoxin administration can minimize toxicity to the kidney. The search for new agents that can improve survival, decrease the need for renal replacement therapy, and hasten the recovery of renal function in ARF is ongoing.

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