Los nuevos medios de contraste NO IÓNICOS que utilizan los Centros de Diagnóstico o los Hospitales de prestigio en Guatemala, no aumentan el riesgo de daño renal agudo, diálisis, o muerte a corto plazo.
Esta es la conclusión del artículo que le enviamos proveniente de los Departamentos de Radiología, Medicina y de Investigación de Ciencias de la Salud de la Universidad de la Clínica Mayo.
La Clínica Mayo revisó 21,346 pacientes, 10,673 recibieron medio de contraste y 10,673 no lo recibieron y su conclusión fue: “La Administración de medio de contraste en exámenes radiológicos, no está asociada con un aumento en el riesgo de daño renal agudo, diálisis o muerte, incluso en pacientes con enfermedades que predisponen a daño renal, como diabetes, fallo cardíaco, enfermedad renal crónica o aguda “.
TecniScan introdujo en Guatemala el uso de la N-ACETIL CISTEINA como protector de la función glomerular (96% del medio de contraste se elimina por ésta vía renal), sin embargo, hay Hospitales universitarios en USA que no lo utilizan, otros en Europa sí lo recomiendan.
“LO MAS IMPORTANTE ES UNA BUENA HIDRATACION DEL PACIENTE DESPUES DEL EXAMEN“
La Clínica Mayo revisó 21,346 pacientes, 10,673 recibieron medio de contraste y 10,673 no lo recibieron y su conclusión fue: “La Administración de medio de contraste en exámenes radiológicos, no está asociada con un aumento en el riesgo de daño renal agudo, diálisis o muerte, incluso en pacientes con enfermedades que predisponen a daño renal, como diabetes, fallo cardíaco, enfermedad renal crónica o aguda “.
TecniScan introdujo en Guatemala el uso de la N-ACETIL CISTEINA como protector de la función glomerular (96% del medio de contraste se elimina por ésta vía renal), sin embargo, hay Hospitales universitarios en USA que no lo utilizan, otros en Europa sí lo recomiendan.
“LO MAS IMPORTANTE ES UNA BUENA HIDRATACION DEL PACIENTE DESPUES DEL EXAMEN“
Muy atentamente, equipo TecniScan Científico.
ARTÍCULO DE REFERENCIA
Intravenous Contrast Material Exposure Is Not an Independent Risk Factor for Dialysis or Mortality
Radiology Select, December 2014, Volume 273: 714-725
Purpose
To determine the risk of emergent dialysis and short-term mortality following intravenous iodinated contrast material exposure.
Materials and Methods
This single-center retrospective study was HIPAA compliant and institutional review board approved. All contrast material–enhanced (contrast group) and unenhanced (noncontrast group) abdominal, pelvic, and thoracic computed tomography scans from 2000–2010 were identified. Patients in the contrast and noncontrast groups were compared following propensity score–based 1:1 matching to reduce intergroup selection bias. Patients with preexisting diabetes mellitus, congestive heart failure, or chronic or acute renal failure were identified as high-risk patient subgroups for nephrotoxicity. The effects of contrast material exposure on the rate of acute kidney injury (AKI) (serum creatinine level ≥ 0.5 mg/dL [44.2 μmol/L] above baseline within 24–72 hours of exposure) and dialysis or death within 30 days of exposure were determined by using odds ratios (ORs) and covariate-adjusted Cox proportional hazards models. Results were validated with a bootstrapped sensitivity analysis.
Results
The 1:1 matching on the basis of the propensity score yielded a cohort of 21 346 patients (10 673 in the contrast group, 10 673 in the noncontrast group). Within this cohort, the risks of AKI (OR, 0.94; 95% confidence interval [CI]: 0.83, 1.07; P = .38), emergent dialysis (OR, 0.96; 95% CI: 0.54, 1.60; P = .89), and 30-day mortality (hazard ratio [HR], 0.97; 95% CI: 0.87, 1.06; P = .45) were not significantly different between the contrast group and the noncontrast group. Although patients who developed AKI had higher rates of dialysis and mortality, contrast material exposure was not an independent risk factor for either outcome for dialysis (OR, 0.89; 95%CI: 0.40, 2.01; P = .78) or for mortality (HR, 1.03; 95% CI: 0.82, 1.32; P = .63), even among patients with compromised renal function or predisposing comorbidities.
Conclusion
Intravenous contrast material administration was not associated with excess risk of AKI, dialysis, or death, even among patients with comorbidities reported to predispose them to nephrotoxicity. © RSNA, 2014
Intravenous Contrast Material Exposure Is Not an Independent Risk Factor for Dialysis or Mortality
Radiology Select, December 2014, Volume 273: 714-725
Purpose
To determine the risk of emergent dialysis and short-term mortality following intravenous iodinated contrast material exposure.
Materials and Methods
This single-center retrospective study was HIPAA compliant and institutional review board approved. All contrast material–enhanced (contrast group) and unenhanced (noncontrast group) abdominal, pelvic, and thoracic computed tomography scans from 2000–2010 were identified. Patients in the contrast and noncontrast groups were compared following propensity score–based 1:1 matching to reduce intergroup selection bias. Patients with preexisting diabetes mellitus, congestive heart failure, or chronic or acute renal failure were identified as high-risk patient subgroups for nephrotoxicity. The effects of contrast material exposure on the rate of acute kidney injury (AKI) (serum creatinine level ≥ 0.5 mg/dL [44.2 μmol/L] above baseline within 24–72 hours of exposure) and dialysis or death within 30 days of exposure were determined by using odds ratios (ORs) and covariate-adjusted Cox proportional hazards models. Results were validated with a bootstrapped sensitivity analysis.
Results
The 1:1 matching on the basis of the propensity score yielded a cohort of 21 346 patients (10 673 in the contrast group, 10 673 in the noncontrast group). Within this cohort, the risks of AKI (OR, 0.94; 95% confidence interval [CI]: 0.83, 1.07; P = .38), emergent dialysis (OR, 0.96; 95% CI: 0.54, 1.60; P = .89), and 30-day mortality (hazard ratio [HR], 0.97; 95% CI: 0.87, 1.06; P = .45) were not significantly different between the contrast group and the noncontrast group. Although patients who developed AKI had higher rates of dialysis and mortality, contrast material exposure was not an independent risk factor for either outcome for dialysis (OR, 0.89; 95%CI: 0.40, 2.01; P = .78) or for mortality (HR, 1.03; 95% CI: 0.82, 1.32; P = .63), even among patients with compromised renal function or predisposing comorbidities.
Conclusion
Intravenous contrast material administration was not associated with excess risk of AKI, dialysis, or death, even among patients with comorbidities reported to predispose them to nephrotoxicity. © RSNA, 2014
Comité Editorial: Grupo de Radiológicos TecniScan.