Annals for Hospitalists Inpatient Notes - What Hospitalists Need to Know About Risk for Contrast-Induced Acute Kidney Injury From Contrast-Enhanced Computed Tomography
Authors: Matthew S. Davenport, Jeffrey C. Weinreb
Journal: Annals of Internal Medicine (2020)

Web Exclusives20 October 2020Annals for Hospitalists Inpatient Notes - What Hospitalists Need to Know About Risk for Contrast-Induced Acute Kidney Injury From Contrast-Enhanced Computed TomographyMatthew S. Davenport, MD and Jeffrey C. Weinreb, MDMatthew S. Davenport, MDMichigan Medicine, Ann Arbor, Michigan (M.S.D.)Search for more papers by this author and Jeffrey C. Weinreb, MDYale New Haven Health, New Haven, Connecticut (J.C.W.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/M20-6296 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail For decades, patients with kidney disease who require contrast-enhanced computed tomography (CT) have had intravenous iodinated contrast media withheld because of concern about contrast-induced acute kidney injury (CI-AKI) (1–3). In most cases, unenhanced CT has been done instead. However, withholding contrast media can impair the diagnostic accuracy and diagnostic confidence for assessment of solid organs (for example, metastasis), hollow viscera (for example, bowel ischemia), and vasculature (for example, thrombosis). During the past 15 years, accumulating data indicate that the risk for CI-AKI from intravenous iodinated contrast media has likely been overstated (1–3). This shift in perceived risk has important implications ...References1. Davenport MS, Perazella MA, Yee J, et al. Use of intravenous iodinated contrast media in patients with kidney disease: consensus statements from the American College of Radiology and the National Kidney Foundation. Radiology. 2020;294:660-668. [PMID: 31961246] doi:10.1148/radiol.2019192094 CrossrefMedlineGoogle Scholar2. American College of Radiology. Manual on Contrast Media. Version 10.3. American College of Radiology; 2020. Accessed at www.acr.org/Clinical-Resources/Contrast-Manual on 26 April 2020. Google Scholar3. Weisbord SD, Gallagher M. Annals for Hospitalists inpatient notes: preventing contrast-associated acute kidney injury—putting the issue to rest. Ann Intern Med. 2019;171:HO2-HO3. [PMID: 31307092]. doi:10.7326/M19-1846 LinkGoogle Scholar4. Dekkers IA, van der Molen AJ. Propensity score matching as a substitute for randomized controlled trials on acute kidney injury after contrast media administration: a systematic review. AJR Am J Roentgenol. 2018;211:822-826. [PMID: 30085838] doi:10.2214/AJR.17.19499 CrossrefMedlineGoogle Scholar5. Ellis JH, Khalatbari S, Yosef M, et al. Influence of clinical factors on risk of contrast-induced nephrotoxicity from IV iodinated low-osmolality contrast material in patients with a low estimated glomerular filtration rate. AJR Am J Roentgenol. 2019;213:W188-W193. [PMID: 31268731] doi:10.2214/AJR.19.21424 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: Michigan Medicine, Ann Arbor, Michigan (M.S.D.)Yale New Haven Health, New Haven, Connecticut (J.C.W.)Acknowledgment: The authors thank Richard H. Cohan, MD, for his thoughtful review of this work.Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M20-6296.Corresponding Author: Matthew S. Davenport, MD, Michigan Medicine, 1500 East Medical Center Drive, Department of Radiology B2-A209A, Ann Arbor, MI 48109; e-mail, [email protected]umich.edu. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoAnnals for Hospitalists - 20 October 2020 David H. Wesorick and Vineet Chopra Metrics 20 October 2020Volume 173, Issue 8Page: HO2-HO3 ePublished: 20 October 2020 Issue Published: 20 October 2020 Copyright & PermissionsCopyright © 2020 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...