Baseline Chloride Levels are Associated with the Incidence of Contrast-Associated Acute Kidney Injury

被引:11
作者
Oh, Hyung Jung [1 ,2 ]
Kim, Sungwon [3 ]
Park, Jung Tak [4 ]
Kim, Sang-Joon [5 ]
Han, Seung Hyeok [4 ]
Yoo, Tae-Hyun [4 ]
Ryu, Dong-Ryeol [1 ,6 ,7 ]
Kang, Shin-Wook [4 ,8 ]
Chung, Yong Eun [3 ,8 ]
机构
[1] Ewha Womans Univ, Mokdong Hosp, Ewha Inst Convergence Med, Seoul, South Korea
[2] Ewha Womans Univ, Mokdong Hosp, Res Inst Human Hlth Informat, Seoul, South Korea
[3] Yonsei Univ, Coll Med, Dept Radiol, 50-1 Yonsei Ro, Seoul 03722, South Korea
[4] Yonsei Univ, Coll Med, Dept Internal Med, Seoul, South Korea
[5] Ewha Womans Univ, Ewha Sch Business, Seoul, South Korea
[6] Ewha Womans Univ, Sch Med, Dept Internal Med, Seoul, South Korea
[7] Ewha Womans Univ, Tissue Injury Def Res Ctr, Seoul, South Korea
[8] Yonsei Univ, Coll Med, PLUS Project Med Sci BK21, Seoul, South Korea
基金
新加坡国家研究基金会;
关键词
AGENT-INDUCED NEPHROPATHY; INTRAVENOUS FLUID; SODIUM-BICARBONATE; METABOLIC-ACIDOSIS; N-ACETYLCYSTEINE; SEVERE SEPSIS; PREVENTION; HYPERCHLOREMIA; HYDRATION; SALINE;
D O I
10.1038/s41598-017-17763-7
中图分类号
O [数理科学和化学]; P [天文学、地球科学]; Q [生物科学]; N [自然科学总论];
学科分类号
07 ; 0710 ; 09 ;
摘要
Although hypo-and hyperchloremia have been associated with worsening renal outcomes, there has been no study that correlates hypo-and hyperchloremia and the incidence of contrast-associated acute kidney injury (CA-AKI). A total of 13,088 patients with less than 2.0 mg/dL of serum creatinine (Cr) who underwent contrast-enhanced abdominal CT (CECT) were included. Patients were divided into 3 groups based on Cl (the hypo-, normo- and hyperchloremia groups). Patients were also classified by baseline Cr (<1.2; the 'Normal Cr group' and 1.2-2.0 mg/dL; the 'Slightly increased Cr group'). Multivariate logistic regression analysis was used to reveal the association between Cl and CA-AKI. Among patients, 2,525 (19.3%) and 241 (1.8%) patients were classified in the hypo-and hyperchloremia group. The incidence of CA-AKI was significantly lower in the normochloremia group (4.0%) compared to the hypo-(5.4%) and hyperchloremia groups (9.5%). On multivariate logistic regression, hypochloremia was significantly associated with the incidence of CA-AKI compared with normochloremia (1.382, P = 0.002). Moreover, hypochloremia was still significantly associated with the incidence of CA-AKI in 'Normal Cr group' compared with normochloremia (1.314, P = 0.015), while hyperchloremia did not show significant association with CA-AKI incidence. In conclusion, hypochloremia might be associated with the incidence of CA-AKI even in patients who have normal-range Cr levels.
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页数:8
相关论文
共 30 条
[1]   What is the best hydration regimen to prevent contrast media-induced nephrotoxicity? [J].
Bader, BD ;
Berger, ED ;
Heede, MB ;
Silberbaur, I ;
Duda, S ;
Risler, T ;
Erley, CM .
CLINICAL NEPHROLOGY, 2004, 62 (01) :1-7
[2]   Acetylcysteine for prevention of contrast nephropathy:: meta-analysis [J].
Birck, R ;
Krzossok, S ;
Markowetz, F ;
Schnülle, P ;
van der Woude, FJ ;
Braun, C .
LANCET, 2003, 362 (9384) :598-603
[3]   Severe Sepsis and Septic Shock REPLY [J].
Angus, Derek C. ;
van der Poll, Tom .
NEW ENGLAND JOURNAL OF MEDICINE, 2013, 369 (21) :2063-2063
[4]   Comparative Effect of Contrast Media Type on the Incidence of Contrast-Induced Nephropathy A Systematic Review and Meta-analysis [J].
Eng, John ;
Wilson, Renee F. ;
Subramaniam, Rathan M. ;
Zhang, Allen ;
Suarez-Cuervo, Catalina ;
Turban, Sharon ;
Choi, Michael J. ;
Sherrod, Cheryl ;
Hutfless, Susan ;
Iyoha, Emmanuel E. ;
Bass, Eric B. .
ANNALS OF INTERNAL MEDICINE, 2016, 164 (06) :417-+
[5]   Reactive Oxygen Species and the Pathogenesis of Radiocontrast-Induced Nephropathy [J].
Heyman, Samuel N. ;
Rosen, Seymour ;
Khamaisi, Mogher ;
Idee, Jean-Marc ;
Rosenberger, Christian .
INVESTIGATIVE RADIOLOGY, 2010, 45 (04) :188-195
[6]   The value of N-acetylcysteine in the prevention of radiocontrast agent-induced nephropathy seems questionable [J].
Hoffmann, U ;
Fischereder, M ;
Krüger, B ;
Drobnik, W ;
Krämer, BK .
JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY, 2004, 15 (02) :407-410
[7]  
Khanna A, 2006, J NEPHROL, V19, pS86
[8]  
Kidney Disease: Improving Global Outcomes (KDIGO) Acute Kidney Injury Work Group, 2012, Kidney Int, V2, P124, DOI [10.1038/kisup.2011.38, DOI 10.1038/KISUP.2011.38, 10.1038/kisup.2012.2, DOI 10.1038/KISUP.2012.1]
[9]   Association of serum chloride concentration with outcomes in postoperative critically ill patients: A retrospective observational study [J].
Kimura S. ;
Matsumoto S. ;
Muto N. ;
Yamanoi T. ;
Higashi T. ;
Nakamura K. ;
Miyazaki M. ;
Egi M. .
Journal of Intensive Care, 2 (1)
[10]   The prevention of radiocontrast-agent-induced nephropathy by hemofiltration [J].
Marenzi, G ;
Marana, I ;
Lauri, G ;
Assanelli, E ;
Grazi, M ;
Campodonico, J ;
Trabattoni, D ;
Fabbiocchi, F ;
Montorsi, P ;
Bartorelli, AL .
NEW ENGLAND JOURNAL OF MEDICINE, 2003, 349 (14) :1333-1340