Brief Articles
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World J Gastroenterol. Mar 28, 2009; 15(12): 1459-1464
Published online Mar 28, 2009. doi: 10.3748/wjg.15.1459
Risk of contrast-induced nephropathy in hospitalized patients with cirrhosis
Nilesh Lodhia, Michael Kader, Thalia Mayes, Parvez Mantry, Benedict Maliakkal
Nilesh Lodhia, Michael Kader, Thalia Mayes, Parvez Mantry, Benedict Maliakkal, Department of Medicine, Division of Gastroenterology and Hepatology, University of Rochester School of Medicine and Dentistry, Box 646 601, Elmwood Avenue, Rochester, NY 14642, United States
Author contributions: Maliakkal B and Mantry P designed the research; Kader M and Mayes T performed the research; Lodhia N, Kader M, Mayes T, Mantry P and Maliakkal B analyzed the data; Lodhia N and Maliakkal B wrote the paper.
Correspondence to: Benedict Maliakkal, MD, Department of Medicine, Division of Gastroenterology and Hepatology, University of Rochester School of Medicine and Dentistry, Box 646 601, Elmwood Avenue, Rochester, NY 14642, United States. benedict_maliakkal@urmc.rochester.edu
Telephone: +1-585-2754711  
Fax: +1-585-2717868
Received: December 25, 2008
Revised: March 5, 2009
Accepted: March 12, 2009
Published online: March 28, 2009
Abstract

AIM: To evaluate the incidence of contrast-induced nephropathy (CIN) in cirrhotic patients and to identify risk factors for the development of CIN.

METHODS: We performed a retrospective review of 216 consecutive patients with cirrhosis who underwent computed tomography (CT) with intravenous contrast at the University of Rochester between the years 2000-2005. We retrospectively examined factors associated with a high risk for CIN, defined as a decrease in creatinine clearance of 25% or greater within one week after receiving contrast.

RESULTS: Twenty-five percent of our patients developed CIN, and 74% of these patients had ascites seen on CT. Of the 75% of patients who did not develop CIN, only 46% had ascites. The presence of ascites was a significant risk factor for the development of CIN (P = 0.0009, OR 3.38, 95% CI 1.55-7.34) in multivariate analysis. Patient age, serum sodium, Model for End-stage Liver Disease score, diuretic use, and the presence of diabetes were not found to be significant risk factors for the development of CIN. Of the patients who developed CIN, 11% developed chronic renal insufficiency, defined as a creatinine clearance less than baseline for 6 wk.

CONCLUSION: Our results suggest that in hospitalized cirrhotic patients, especially those with ascites, the risk of CIN is substantial.

Keywords: Ascites; Cirrhosis; Contrast-induced nephropathy; Renal failure