Journal
INVESTIGATIVE RADIOLOGY
Volume 51, Issue 12, Pages 797-803Publisher
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/RLI.0000000000000268
Keywords
iodinated contrast media; computed tomography; acute kidney injury; cardiac catheterization; urinary biomarkers; nephrogram
Funding
- National Center for Advancing Translation Sciences, National Institutes of Health [ULI TR000002]
- Siemens Healthcare, Forchheim, Germany
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Objectives: We evaluate the relationships between persistent computed tomography (CT) nephrograms and acute kidney injury after cardiac catheterization (CC). We compare changes in urinary biomarkers kidney injury molecule 1 (KIM-1), cystatin C, and serum creatinine to procedural factors. Materials and Methods: From 159 eligible patients without renal insufficiency (estimated glomerular filtration rate >60 mL/min), 40 random patients (age range, 42-81 years; mean age, 64 years; 25 men, 15 women) gave written informed consent to undergo unenhanced CT limited to their kidneys 24 hours after CC. Semi-quantitative assessment for global nephrograms and quantitative assessment of focal nephrograms in each kidney was performed. Computed tomography attenuation (Hounsfield units) of the renal cortex was measured. Serum creatinine, KIM-1, and cystatin C were measured before and 24 hours after CC. Results: Robust linear regression showed that both relative changes in KIM-1 and cystatin C had positive relationships with kidney CT attenuation (P = 0.012 and 0.002, respectively). Spearman rank correlation coefficient showed that both absolute changes and relative changes in KIM-1 and cystatin C had positive correlations with global nephrogram grades (P = 0.025 and 0.040, respectively, for KIM-1; P = 0.013 and 0.019, respectively, for cystatin C). Conclusions: Global nephrograms on unenhanced CT in patients who have undergone CC are significantly correlated with changes in urinary biomarkers for kidney damage.
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