Risk characteristics and incidence of contrast nephrotoxicity in patients exposed to intravascular contrast at Kenyatta National Hospital.
Abstract
BROAD OBJECTIVE: To determine the incidence and associated risk factors for
developing contrast media induced nephropathy in adult patients undergoing
intravascularcontrast enhanced imaging procedures at Kenyatta National Hospital.
STUDY DESIGN: A prospective/descriptive survey
STUDY POPULATION: Adult patients above 13 years of age undergoing
intravascular contrast enhanced imaging procedures at the radiology department
andcardiac catheterization laboratory at Kenyatta National Hospital.
STUDY SETTING: This study was carried out in the departments of radiology and
cardiaccatheterization laboratory of Kenyatta National Hospital.
METHODOLOGY: Consecutive sampling of 177 patients undergoing contrast
enhanced studies was done. Venous blood for serum creatinine sodium, potassium
and urea levels determination was drawn at baseline, at 24 and 72 hours after
contrast administration. A patient was considered to have developed contrast
nephropathy if there were 44.2 umol/l, absolute increases in serum creatinine from
the baseline within 72 hours of contrast administration.
DATA ANALYSIS: Data was analyzed using SPSS version 15.1
RESULTS: The results of serum creatinine changes at 24 and 72 hours were
analyzed against patient's demographic data and known risk factors for contrast
nephropathy.Contrast nephropathy was found to occur in 21.3% at 24hrs and 30.7
% at 72 hrs. Cumulative incidence was 32.8%.lt was found to occur in increasing
frequency with increase in the number of risk factors, age, amount of contrast and
dehydration.
CONCLUSION: CIN is common in patients exposed to contrast at KNH
CIN is even more common in patients with known risk factors e.g. pre-existing renal
insufficiency, eldely, dehydration, and exposure to large volumes of contrast load
Riskfor CIN worsens with multiplicity of risk factors.
CIN incidence compares with others reported in other studies, inspite of differences
in type of procedures most reported
Citation
Masters of medicine in internal medicineSponsorhip
University of NairobiPublisher
Department of medicine University of Nairobi