1-Year Mortality Following Contrast-Induced Nephropathy

Alice M. Mitchell; Alan E. Jones; James A. Tumlin; Jeffrey A. Kline

doi:doi:10.11648/j.ajim.20130101.11

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1-Year Mortality Following Contrast-Induced Nephropathy

Alice M. Mitchell, Alan E. Jones, James A. Tumlin, Jeffrey A. Kline

Published in American Journal of Internal Medicine (Volume 1, Issue 1)

Received: 23 April 2013 Published: 2 May 2013

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Abstract

Objective: The aim of this study was to determine the 1-year mortality risk subsequent to Contrast-Induced Nephropathy (CIN) following CECT imaging, relative to other well-recognized predictors of mortality. Methods: We followed a prospective, consecutive cohort of ambulatory patients who received intravenous contrast for CECT for the outcome of death from any cause within 1 year. In a multivariate analysis, we compared CIN with other predictors of mortality: active malignancy, coronary artery disease (CAD), congestive heart failure (CHF) and age ≥70 years. Anticipating that terminal cancers would account for the majority of deaths in this population, we also analyzed the subset of patients without an active malignancy at the time of enrollment. Results: We followed 633 patients and 46 died (7%, 95%CI: 5-9%) within 1 year. The incidence of CIN was 11% (95%CI: 8-14%). Active malignancy (HR 9.2, 95%CI: 5.1-16.8), CIN (HR 2.4, 95%CI: 1.3-4.6), CHF (HR 2.1, 95%CI: 1.0-4.2), CAD (HR 2.2, 95%CI: 1.0-5.5) and age ≥70 years (HR 1.8, 95%CI: 1.0-3.8) were significant predictors of all-cause mortality. Among patients without active malignancies, the mortality rate was 4% (25/580, 95%CI: 3-6%) and CIN (HR 4.0, 95%CI: 1.7-9.6) and age ≥70 years (HR 3.7, 95%CI: 1.4-9.7) were significantly associated with death, whereas CAD (HR 2.5, 95%CI: 0.8-7.7) and CHF (HR 1.8, 95%CI: 0.6-5.3) were not. Conclusions: The development of CIN following CECT is associated with an increased likelihood of death at 1 year among patients with and without active malignancies, comparable to CAD, CHF and advanced age.

Published in	American Journal of Internal Medicine (Volume 1, Issue 1)
DOI	10.11648/j.ajim.20130101.11
Page(s)	1-6
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2013. Published by Science Publishing Group

Keywords

Acute Kidney Injury, Mortality, Contrast Media, Computed Tomography, Outpatients

References

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[2]	Tumlin J, Stacul F, Adam A, et al. Pathophysiology of contrast-induced nephropathy. The American journal of cardiology. 2006;98(6A):14K-20K.
[3]	From AM, Bartholmai BJ, Williams AW, et al. Sodium bicarbonate is associated with an increased incidence of contrast nephropathy: a retrospective cohort study of 7977 patients at mayo clinic. Clinical journal of the American Society of Nephrology : CJASN. 2008;3(1):10-8.
[4]	Katzberg RW, Barrett BJ. Risk of iodinated contrast material--induced nephropathy with intravenous administration. Radiology. 2007;243(3):622-8.
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[8]	Mitchell AM, Jones AE, Tumlin JA, Kline JA. Incidence of contrast-induced nephropathy after contrast-enhanced computed tomography in the outpatient setting. Clinical journal of the American Society of Nephrology : CJASN. 2010;5(1):4-9.
[9]	Kline JA, Mitchell AM, Runyon MS, et al. Electronic medical record review as a surrogate to telephone follow-up to establish outcome for diagnostic research studies in the emergency department. Academic emergency medicine : official journal of the Society for Academic Emergency Medicine. 2005;12(11):1127-33.
[10]	Mitchell AM, Jones AE, Tumlin JA, Kline JA. Prospective study of the incidence of contrast-induced nephropathy among patients evaluated for pulmonary embolism by contrast-enhanced computed tomography. Academic emergency medicine : official journal of the Society for Academic Emergency Medicine. 2012;19(6):618-25.
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[13]	Mitchell AM, Kline JA. Contrast-induced nephropathy: doubts and certainties. Academic emergency medicine : official journal of the Society for Academic Emergency Medicine. 2012;19(11):1294-6.
[14]	Anderson S, Eldadah B, Halter JB, et al. Acute kidney injury in older adults. Journal of the American Society of Nephrology : JASN. 2011;22(1):28-38.
[15]	Xue JL, Daniels F, Star RA, et al. Incidence and mortality of acute renal failure in Medicare beneficiaries, 1992 to 2001. Journal of the American Society of Nephrology : JASN. 2006;17(4):1135-42.
[16]	Coca SG, Yusuf B, Shlipak MG, et al. Long-term risk of mortality and other adverse outcomes after acute kidney injury: a systematic review and meta-analysis. American journal of kidney diseases : the official journal of the National Kidney Foundation. 2009;53(6):961-73.
[17]	McCullough PA, Adam A, Becker CR, et al. Risk prediction of contrast-induced nephropathy. The American journal of cardiology. 2006;98(6A):27K-36K.
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APA Style

Alice M. Mitchell, Alan E. Jones, James A. Tumlin, Jeffrey A. Kline. (2013). 1-Year Mortality Following Contrast-Induced Nephropathy. American Journal of Internal Medicine, 1(1), 1-6. https://doi.org/10.11648/j.ajim.20130101.11

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ACS Style

Alice M. Mitchell; Alan E. Jones; James A. Tumlin; Jeffrey A. Kline. 1-Year Mortality Following Contrast-Induced Nephropathy. Am. J. Intern. Med. 2013, 1(1), 1-6. doi: 10.11648/j.ajim.20130101.11

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AMA Style

Alice M. Mitchell, Alan E. Jones, James A. Tumlin, Jeffrey A. Kline. 1-Year Mortality Following Contrast-Induced Nephropathy. Am J Intern Med. 2013;1(1):1-6. doi: 10.11648/j.ajim.20130101.11

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@article{10.11648/j.ajim.20130101.11,
  author = {Alice M. Mitchell and Alan E. Jones and James A. Tumlin and Jeffrey A. Kline},
  title = {1-Year Mortality Following Contrast-Induced Nephropathy},
  journal = {American Journal of Internal Medicine},
  volume = {1},
  number = {1},
  pages = {1-6},
  doi = {10.11648/j.ajim.20130101.11},
  url = {https://doi.org/10.11648/j.ajim.20130101.11},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajim.20130101.11},
  abstract = {Objective: The aim of this study was to determine the 1-year mortality risk subsequent to Contrast-Induced Nephropathy (CIN) following CECT imaging, relative to other well-recognized predictors of mortality. Methods: We followed a prospective, consecutive cohort of ambulatory patients who received intravenous contrast for CECT for the outcome of death from any cause within 1 year. In a multivariate analysis, we compared CIN with other predictors of mortality: active malignancy, coronary artery disease (CAD), congestive heart failure (CHF) and age ≥70 years. Anticipating that terminal cancers would account for the majority of deaths in this population, we also analyzed the subset of patients without an active malignancy at the time of enrollment. Results: We followed 633 patients and 46 died (7%, 95%CI: 5-9%) within 1 year. The incidence of CIN was 11% (95%CI: 8-14%). Active malignancy (HR 9.2, 95%CI: 5.1-16.8), CIN (HR 2.4, 95%CI: 1.3-4.6), CHF (HR 2.1, 95%CI: 1.0-4.2), CAD (HR 2.2, 95%CI: 1.0-5.5) and age ≥70 years (HR 1.8, 95%CI: 1.0-3.8) were significant predictors of all-cause mortality. Among patients without active malignancies, the mortality rate was 4% (25/580, 95%CI: 3-6%) and CIN (HR 4.0, 95%CI: 1.7-9.6) and age ≥70 years (HR 3.7, 95%CI: 1.4-9.7) were significantly associated with death, whereas CAD (HR 2.5, 95%CI: 0.8-7.7) and CHF (HR 1.8, 95%CI: 0.6-5.3) were not. Conclusions: The development of CIN following CECT is associated with an increased likelihood of death at 1 year among patients with and without active malignancies, comparable to CAD, CHF and advanced age.},
 year = {2013}
}

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TY  - JOUR
T1  - 1-Year Mortality Following Contrast-Induced Nephropathy
AU  - Alice M. Mitchell
AU  - Alan E. Jones
AU  - James A. Tumlin
AU  - Jeffrey A. Kline
Y1  - 2013/05/02
PY  - 2013
N1  - https://doi.org/10.11648/j.ajim.20130101.11
DO  - 10.11648/j.ajim.20130101.11
T2  - American Journal of Internal Medicine
JF  - American Journal of Internal Medicine
JO  - American Journal of Internal Medicine
SP  - 1
EP  - 6
PB  - Science Publishing Group
SN  - 2330-4324
UR  - https://doi.org/10.11648/j.ajim.20130101.11
AB  - Objective: The aim of this study was to determine the 1-year mortality risk subsequent to Contrast-Induced Nephropathy (CIN) following CECT imaging, relative to other well-recognized predictors of mortality. Methods: We followed a prospective, consecutive cohort of ambulatory patients who received intravenous contrast for CECT for the outcome of death from any cause within 1 year. In a multivariate analysis, we compared CIN with other predictors of mortality: active malignancy, coronary artery disease (CAD), congestive heart failure (CHF) and age ≥70 years. Anticipating that terminal cancers would account for the majority of deaths in this population, we also analyzed the subset of patients without an active malignancy at the time of enrollment. Results: We followed 633 patients and 46 died (7%, 95%CI: 5-9%) within 1 year. The incidence of CIN was 11% (95%CI: 8-14%). Active malignancy (HR 9.2, 95%CI: 5.1-16.8), CIN (HR 2.4, 95%CI: 1.3-4.6), CHF (HR 2.1, 95%CI: 1.0-4.2), CAD (HR 2.2, 95%CI: 1.0-5.5) and age ≥70 years (HR 1.8, 95%CI: 1.0-3.8) were significant predictors of all-cause mortality. Among patients without active malignancies, the mortality rate was 4% (25/580, 95%CI: 3-6%) and CIN (HR 4.0, 95%CI: 1.7-9.6) and age ≥70 years (HR 3.7, 95%CI: 1.4-9.7) were significantly associated with death, whereas CAD (HR 2.5, 95%CI: 0.8-7.7) and CHF (HR 1.8, 95%CI: 0.6-5.3) were not. Conclusions: The development of CIN following CECT is associated with an increased likelihood of death at 1 year among patients with and without active malignancies, comparable to CAD, CHF and advanced age.
VL  - 1
IS  - 1
ER  -

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Author Information

Alice M. Mitchell

Department of Emergency Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
Alan E. Jones

Department of Emergency Medicine, University of Mississippi Medical Center, Jackson, MS, USA
James A. Tumlin

University of Tennessee, Chattanooga College of Medicine, Chattanooga, TN, USA
Jeffrey A. Kline

Department of Emergency Medicine, Indiana University School of Medicine, Indianapolis, IN, USA

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Plain Text BibTeX RIS

APA Style

Alice M. Mitchell, Alan E. Jones, James A. Tumlin, Jeffrey A. Kline. (2013). 1-Year Mortality Following Contrast-Induced Nephropathy. American Journal of Internal Medicine, 1(1), 1-6. https://doi.org/10.11648/j.ajim.20130101.11

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ACS Style

Alice M. Mitchell; Alan E. Jones; James A. Tumlin; Jeffrey A. Kline. 1-Year Mortality Following Contrast-Induced Nephropathy. Am. J. Intern. Med. 2013, 1(1), 1-6. doi: 10.11648/j.ajim.20130101.11

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AMA Style

Alice M. Mitchell, Alan E. Jones, James A. Tumlin, Jeffrey A. Kline. 1-Year Mortality Following Contrast-Induced Nephropathy. Am J Intern Med. 2013;1(1):1-6. doi: 10.11648/j.ajim.20130101.11

Copy | Download

@article{10.11648/j.ajim.20130101.11,
  author = {Alice M. Mitchell and Alan E. Jones and James A. Tumlin and Jeffrey A. Kline},
  title = {1-Year Mortality Following Contrast-Induced Nephropathy},
  journal = {American Journal of Internal Medicine},
  volume = {1},
  number = {1},
  pages = {1-6},
  doi = {10.11648/j.ajim.20130101.11},
  url = {https://doi.org/10.11648/j.ajim.20130101.11},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajim.20130101.11},
  abstract = {Objective: The aim of this study was to determine the 1-year mortality risk subsequent to Contrast-Induced Nephropathy (CIN) following CECT imaging, relative to other well-recognized predictors of mortality. Methods: We followed a prospective, consecutive cohort of ambulatory patients who received intravenous contrast for CECT for the outcome of death from any cause within 1 year. In a multivariate analysis, we compared CIN with other predictors of mortality: active malignancy, coronary artery disease (CAD), congestive heart failure (CHF) and age ≥70 years. Anticipating that terminal cancers would account for the majority of deaths in this population, we also analyzed the subset of patients without an active malignancy at the time of enrollment. Results: We followed 633 patients and 46 died (7%, 95%CI: 5-9%) within 1 year. The incidence of CIN was 11% (95%CI: 8-14%). Active malignancy (HR 9.2, 95%CI: 5.1-16.8), CIN (HR 2.4, 95%CI: 1.3-4.6), CHF (HR 2.1, 95%CI: 1.0-4.2), CAD (HR 2.2, 95%CI: 1.0-5.5) and age ≥70 years (HR 1.8, 95%CI: 1.0-3.8) were significant predictors of all-cause mortality. Among patients without active malignancies, the mortality rate was 4% (25/580, 95%CI: 3-6%) and CIN (HR 4.0, 95%CI: 1.7-9.6) and age ≥70 years (HR 3.7, 95%CI: 1.4-9.7) were significantly associated with death, whereas CAD (HR 2.5, 95%CI: 0.8-7.7) and CHF (HR 1.8, 95%CI: 0.6-5.3) were not. Conclusions: The development of CIN following CECT is associated with an increased likelihood of death at 1 year among patients with and without active malignancies, comparable to CAD, CHF and advanced age.},
 year = {2013}
}

Copy | Download

TY  - JOUR
T1  - 1-Year Mortality Following Contrast-Induced Nephropathy
AU  - Alice M. Mitchell
AU  - Alan E. Jones
AU  - James A. Tumlin
AU  - Jeffrey A. Kline
Y1  - 2013/05/02
PY  - 2013
N1  - https://doi.org/10.11648/j.ajim.20130101.11
DO  - 10.11648/j.ajim.20130101.11
T2  - American Journal of Internal Medicine
JF  - American Journal of Internal Medicine
JO  - American Journal of Internal Medicine
SP  - 1
EP  - 6
PB  - Science Publishing Group
SN  - 2330-4324
UR  - https://doi.org/10.11648/j.ajim.20130101.11
AB  - Objective: The aim of this study was to determine the 1-year mortality risk subsequent to Contrast-Induced Nephropathy (CIN) following CECT imaging, relative to other well-recognized predictors of mortality. Methods: We followed a prospective, consecutive cohort of ambulatory patients who received intravenous contrast for CECT for the outcome of death from any cause within 1 year. In a multivariate analysis, we compared CIN with other predictors of mortality: active malignancy, coronary artery disease (CAD), congestive heart failure (CHF) and age ≥70 years. Anticipating that terminal cancers would account for the majority of deaths in this population, we also analyzed the subset of patients without an active malignancy at the time of enrollment. Results: We followed 633 patients and 46 died (7%, 95%CI: 5-9%) within 1 year. The incidence of CIN was 11% (95%CI: 8-14%). Active malignancy (HR 9.2, 95%CI: 5.1-16.8), CIN (HR 2.4, 95%CI: 1.3-4.6), CHF (HR 2.1, 95%CI: 1.0-4.2), CAD (HR 2.2, 95%CI: 1.0-5.5) and age ≥70 years (HR 1.8, 95%CI: 1.0-3.8) were significant predictors of all-cause mortality. Among patients without active malignancies, the mortality rate was 4% (25/580, 95%CI: 3-6%) and CIN (HR 4.0, 95%CI: 1.7-9.6) and age ≥70 years (HR 3.7, 95%CI: 1.4-9.7) were significantly associated with death, whereas CAD (HR 2.5, 95%CI: 0.8-7.7) and CHF (HR 1.8, 95%CI: 0.6-5.3) were not. Conclusions: The development of CIN following CECT is associated with an increased likelihood of death at 1 year among patients with and without active malignancies, comparable to CAD, CHF and advanced age.
VL  - 1
IS  - 1
ER  -

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