Contrast Medium Exposure During Computed Tomography and Risk of Development of End-Stage Renal Disease in Patients With Chronic Kidney Disease A Nationwide Population-Based, Propensity Score-Matched, Longitudinal Follow-Up Study

被引：23

作者：

Hsieh, Ming-Shun ^{[1
,2
,3
,4
]}

Chiu, Chien-Shan ^{[4
,5
,6
]}

How, Chorng-Kuang ^{[4
]}

Chiang, Jen-Huai ^{[7
,8
,9
]}

Sheu, Meei-Ling ^{[6
]}

Chen, Wen-Chi ^{[9
,10
,11
,12
,13
]}

Lin, Hsuan-Jen ^{[14
,15
]}

Hsieh, Vivian Chia-Rong ^{[16
]}

Hu, Sung-Yuan ^{[17
,18
,19
]}

机构：

[1] Taipei Vet Gen Hosp, Dept Emergency Med, Taoyuan Branch, Taoyuan, Taiwan

[2] Taipei Vet Gen Hosp, Dept Emergency Med, Taipei, Taiwan

[3] Natl Taiwan Univ, Coll Publ Hlth, Inst Occupat Med & Ind Hyg, Taipei 10764, Taiwan

[4] Natl Yang Ming Univ, Sch Med, Taipei 112, Taiwan

[5] Taichung Vet Gen Hosp, Dept Dermatol, Taichung, Taiwan

[6] Natl Chung Hsing Univ, Inst Biomed Sci, Taichung 40227, Taiwan

[7] China Med Univ, Management Off Hlth Data, Taichung, Taiwan

[8] China Med Univ, Coll Med, Taichung, Taiwan

[9] China Med Univ, Grad Inst Integrated Med, Coll Chinese Med, Res Ctr Chinese Med & Acupuncture, Taichung, Taiwan

[10] China Med Univ, Sex Hormone Res Ctr, Dept Obstet & Gynecol, Taichung, Taiwan

[11] China Med Univ, Sex Hormone Res Ctr, Dept Urol, Taichung, Taiwan

[12] China Med Univ, Sex Hormone Res Ctr, Dept Med Res, Taichung, Taiwan

[13] China Med Univ, Dept Med Res, Obstet & Gynecol Dermatol & Urol, Taichung, Taiwan

[14] China Med Univ, Kidney Inst, Dept Internal Med, Taichung, Taiwan

[15] China Med Univ, Div Nephrol, Dept Internal Med, Taichung, Taiwan

[16] China Med Univ, Dept Hlth Serv Adm, Taichung, Taiwan

[17] Taichung Vet Gen Hosp, Dept Emergency Med, Taichung, Taiwan

[18] Chung Shan Med Univ, Inst Med, Taichung, Taiwan

[19] Natl Taichung Univ Sci & Technol, Dept Nursing, Coll Hlth, Taichung, Taiwan

来源：

MEDICINE | 2016年 / 95卷 / 16期

关键词：

PERCUTANEOUS CORONARY INTERVENTION; MEDIUM-INDUCED NEPHROPATHY; RANDOMIZED CONTROLLED-TRIAL; SODIUM-BICARBONATE; N-ACETYLCYSTEINE; MYOCARDIAL-INFARCTION; DIABETES-MELLITUS; PREVENTION; NEPHROTOXICITY; ANGIOGRAPHY;

D O I：

10.1097/MD.0000000000003388

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

The aim of the study was to investigate the long-term association between contrast medium exposure during computed tomography (CT) and the subsequent development of end-stage renal disease (ESRD) in patients with chronic kidney disease (CKD). We conducted a population-based cohort study using Taiwan's National Health Insurance Research Database. A total of 7100 patients with nonadvanced CKD who underwent contrast medium-enhanced CT were identified and served as the study cohort. To avoid selection bias, we used the propensity score to match 7100 nonadvanced CKD patients, who underwent noncontrast medium-enhanced CT to serve as the comparison cohort. The age, sex, index year, and frequency of undergoing CTs were also matched between the study and comparison cohorts. Participants were followed until a new diagnosis of ESRD or December 31, 2011. Hazard ratios (HRs) with 95% confidence interval (95% CI) were calculated using the Cox proportional hazards regression. Contrast medium exposure was not identified as a risk factor for developing ESRD in nonadvanced CKD patients after confounders adjustment (adjusted HR = 0.91; 95% CI, 0.66-1.26; P = 0.580). We further divided the patients who underwent CTs with contrast medium use into <= 1 exposure per year on average, >1 and <2 exposure per year on average, and >= 2 exposure per year on average. After adjusting for confounders, we identified a much higher risk for developing ESRD in the 2 groups of >1 and< 2 exposure per year on average and >= 2 exposure per year on average (adjusted HR = 8.13; 95% CI, 5.57-11.87 and adjusted HR = 12.08; 95% CI, 7.39-19.75, respectively) compared with the patients who underwent CTs without contrast medium use. This long-term follow-up study demonstrated that contrast medium exposure was not associated with an increased risk of ESRD development in nonadvanced CKD patients.

引用

页数：9

共 57 条

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