ABSTRACT
Abstract Objective: To determine the incidence of nephropathy induced by intravenous contrast in hospitalized patients undergoing computed tomography (CT). Materials and Methods: This was a retrospective cohort study involving 1,238 patients who underwent CT with or without intravenous administration of a contrast agent (iopromide). The primary outcome measure was acute kidney injury (AKI), as defined by the traditional criteria-an absolute or relative increase in serum creatinine (SCr) ≥ 0.5 mg/dL or ≥ 25% over baseline, respectively, at 2-3 days after contrast administration-and the newer, Kidney Disease: Improving Global Outcomes (KDIGO) criteria-an absolute or relative increase in SCr ≥ 0.3 mg/dL or ≥ 50% over baseline, respectively, at 2-7 days after contrast administration. Results: The overall incidence of AKI was 11.52% when the KDIGO criteria were applied. Univariate logistic regression demonstrated a significant association between an absolute post-CT increase in SCr ≥ 0.5 mg/dL and AKI, although that association did not retain significance in the multivariate analysis. Multivariate logistic regression initially found an association between an absolute post-CT increase in SCr ≥ 0.3 mg/dL and advanced age, although that association was not maintained after correction. We found no association between AKI and the risk factors evaluated. Conclusion: We identified no criteria for contrast-induced nephropathy after CT; nor did we find AKI to be associated with the classical risk factors.
Resumo Objetivo: Determinar a incidência de nefropatia induzida por contraste intravenoso em pacientes hospitalizados submetidos a tomografia computadorizada (TC). Materiais e Métodos: Estudo de coorte retrospectivo que alocou 1.238 pacientes submetidos a TC sem ou com contraste (iopromida). O desfecho primário foi nefropatia induzida por contraste, definida pelo critério antigo - aumento absoluto ou relativo na creatinina sérica (SCr) ≥ 0,5 mg/dL ou ≥ 25%, respectivamente, durante 2-3 dias após a administração -, e o novo, Kidney Disease Improving Global Outcomes (KDIGO) - aumento absoluto ou relativo na SCr ≥ 0,3 mg/dL ou ≥ 50%, respectivamente, durante 2-7 dias após a administração. Resultados: A incidência de lesão renal aguda foi de 11,52% aplicando os critérios KDIGO. A regressão logística univariada demonstrou significância relacionada à associação entre aumento absoluto da SCr ≥ 0,5 mg/dL após TC e lesão renal aguda. A regressão logística multivariada encontrou, inicialmente, associação entre aumento absoluto da SCr ≥ 0,3 mg/dL após TC e idade avançada, mas a associação não foi mantida após correção. Não foi encontrada associação entre lesão renal aguda e os fatores de risco avaliados. Conclusão: Não foram encontrados critérios para nefropatia induzida por contraste após TC ou associação de lesão renal aguda com fatores de risco clássicos.
ABSTRACT
Objective To establish an accurate,simple,safe,cheap,and logical new adult Chinese formula for measurement and calculation of glomerular filtration rate (eGFR).Methods GFRs from 136 cases of patients in hospital suffering from the different diseases were determined accurately using clearance rate of 99mTc-DTPA (Tc-GFR),and many clinical factors including serum creatinine (SCr) were determined simultaneously with routine method.The new equation for adult Chinese based on the SCr was obtained by the relationship and regression analysis for measurement and calculation GFR (SCrAC-eGFR).Tc-GFR from another 117 cases of patients were determined by the same method.SCr,and blood urea nitrogen were determined using routine method.eGFR were measured and calculated by 12 formulae such as SCrAC-eGFR,and USA DMS method.The relationship analysis and the contrast study from all data were performed.Results The equation was tenable,and the regression coefficient was significant ( P ＜ 0.01 ).eGFR from the six formulae for example SCrAC-eGFR,USA DMS method,Japan Picric method and so on could all give expression to GFR accurately at the some extent and the SCrAC-eGFR new formulae and USA DMS method formulae was more accurately than other and could take the place of Tc-GFR clinically.Conclusions The six formulae including SCrAC-eGFR,and USA DMS method were all accurate,simple,celer,safe,cheap,and rational methods for estimating GFR.It should apply and popularize clinically.
ABSTRACT
[Objective] To observe the effects of spleen-strengthening and kidney-invigorating prescription (SSKTP) on nutritional status in rats with chronic renal failure (CRF) . [Methods] CRF rat models were established by 5/6 subtotal nephrectomy. Rats were divided into group A (normal control) , B (model), C (high- dose SSKIP) and D (low-dose SSKIP). Contents of serum creatinine (Cr), blood urea nitrogen (BUN), C-reactive protein (CRP), urine Cr and hemoglobin (Hb) in peripheral blood , glomerular filtration rate (GFR), area body weight (ABW) index and pathological features of renal tissues were observed. [ Results ] In SSKIP groups, Hb content and ABW index were increased (P
ABSTRACT
Objective To investigate the renal hemodynamic changes after orthotopic liver transplantation(OLT)and the correlative parameters. Methods In 20 patients undergoing OLT for cirrhosis,the following renal arterial resistance index(RI) was measured before surgery and 7days,30days, 6 months and 1 year after operation by using color Doppler flow imaging(CDFI) and serum creatinine detection.Meanwhile the same parameters were measured in 10 healthy as controls. Results Both RI and serum Cr rised after OLT ( P 0.05). Conclusions Most alteration of renal hemodynamic parameters in cirrhosis are restored to normal after OLT in 1 year. Preoperative renal abnormalities and intraopterative alteration of hemodynamic may contribute to postoperative renal dysfunction. Cyclosporine (CsA) is the most likely etiologic agent of postoperative renal dysfunction.