Administration of iodinated contrast: What is the risk in cancer patients?

OBJECTIVE: Despite the association between intravenous contrast and kidney injury, few studies exist in oncology. Our objective was to estimate kidney outcomes following iodinated contrast-enhanced computed tomography (CECT) in cancer patients, and to evaluate whether self-assessment questionnaires can identify kidney injury risk factors. METHODS: This prospective observational study included 289 patients who underwent a CECT scan between March and May 2017 in a hospital setting. All patients completed the modified European Society of Urogenital Radiology (ESUR) questionnaire and had an estimated glomerular filtration rate (eGFR) >30 ml/min/1.73 m2 on the day of the examination. Outcomes were followed for 4 months. Univariate and logistic regression analyses were carried out. RESULTS: In the logistic regression analysis, the only variables statistically associated with deterioration in the eGFR were age, (odds ratio (OR) = 1.091, p = 0.003), female sex, (OR 0.22, p = 0.020) and arterial hypertension (AH), (OR = 3.57, p = 0.019). Regarding exitus, only the group with a worse eGFR was close to predictive statistical significance (OR = 2.48, p = 0.09). CONCLUSIONS: The administration of iodinated contrast in cancer patients was not associated with an increase in kidney outcomes. Risk factors in these patients were age, sex and AH.