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Radiología
Article . 2019 . Peer-reviewed
License: Elsevier TDM
Data sources: Crossref
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Administración de medios de contraste. ¿Existe riesgo de daño renal agudo?

Authors: M.D. Ferrer Puchol; P. Montesinos García; M. Forment Navarro; E. Sanz Rodrigo; E. Blanco Pérez; E. Taberner López;

Administración de medios de contraste. ¿Existe riesgo de daño renal agudo?

Abstract

Resumen Objetivo Conocer si la administracion intravenosa de contraste yodado en la tomografia computarizada (TC) se asocia a un aumento en los niveles de creatinina y de dano renal agudo. Material y metodos Estudio de cohortes retrospectivo. Incluye todos los pacientes que acudieron al servicio de urgencias del 2010 al 2015 y que presentaban una creatinina basal (C1) y otra 24-72 horas despues (C2). El Comite de Etica y de Investigacion aprobo el estudio. Criterios de exclusion: paciente menor de 18 anos, creatinina ≤ 0,4 mg/dl, ≥4,0 mg/dl y administracion de contraste en los ultimos 6 meses. Al servicio de urgencias acudieron una media de 105.435,6 pacientes/ano. Tres grupos de pacientes: 1) TC con contraste (6.642), 2) TC sin contraste (6.193,3) y 3) Sin TC (33.802). Se usaron los criterios de Acute Kidney Injury Network (AKI) y nefropatia aguda por contraste (NAC). Se realizo estudio estadistico bivariante y de regresion logistica con el programa (Stata15). Resultados Se analizaron 52.411 pacientes; depurando datos: 46.637. Edad media: 67,95 anos. Valor de C1: media 1,16 mg/dl (DE: 0,61) y de C2: 1,14 mg/dl (DE: 0,66). Con criterios AKI y NAC: la realizacion de TC con contraste no se asocia a una mayor probabilidad de desarrollar nefropatia (odds ratio [OR]: 0,90, intervalo de confianza [IC]: 0,83-0,99 y OR 0,89, IC: 0,81-0,98, respectivamente). El estudio “propensity score matching”, usando ambos criterios (AKI + NAC), obtuvo una OR de 0,80 y una IC de 0,77-0,84. Pacientes con filtrado glomerular inferior a 30 ml/min no asociaron incremento del dano renal (OR: 0,66, IC: 0,47-0,91). Conclusion La administracion de contraste intravenoso, en el grupo de pacientes estudiados, no esta asociada a un aumento del dano renal agudo.

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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
6
Top 10%
Average
Top 10%
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