Low Incidence of Acute Renal Failure with Minimal Prophylaxis after Iodinated-Contrast TC in Ambulatory Renal Transplant Patients

C. Jimenez¹, S. Afonso¹, M. O. Lopez¹, M. E. Gonzalez¹, M. J. Santana¹, A. Santiago², M. A. Vaca¹, M. Ferreira¹, R. Selgas¹

¹Nephrology, Hospital Universitario La Paz, Madrid, Spain, ²Radiology, Hospital Universitario La Paz, Madrid, Spain

Meeting: 2019 American Transplant Congress

Abstract number: C69

Keywords: Kidney transplantation, Nephrotoxicity, Prophylaxis, Renal dysfunction

Session Information

Session Name: Poster Session C: Kidney Complications: Late Graft Failure

Session Type: Poster Session

Date: Monday, June 3, 2019

Session Time: 6:00pm-7:00pm

Presentation Time: 6:00pm-7:00pm

Location: Hall C & D

*Purpose: Kidney transplant patients are at risk of contrast-induced nephropathy. CT scan with contrast is a very common imaging test. Our objective is to study the incidence of acute kidney injury in ambulatory kidney allograft patients who are made a CT scan with contrast, with short prophylasis

*Methods: Retrospective longitudinal study which includes patients with kidney transplant and a CT scan with hypoosmolar contrast, made between 2014 and 2016. All of the subjects received previous prophylaxis with saline solution, at a volume of 500-1000 ml during one or two hour depending on whether they had cardiology diseases or not respectively. Kidney function was analysed 5-7 days after the imaging test was made. Acute kidney injury was defined as an elevation in creatinine levels ≥ 0.3 mg/dl within 48 hours since the contrast was administered or as an increase of 150% from baseline values in 7 days not attributable to other causes.

*Results: 4 in 61 patients had contrast-induced nephropathy (6.1%). This entity was more frequent in patients who were diagnosed of renal artery stenosis (p 0.027), and in those with a higher body mass index if they were on calcineurin inhibitors (p 0.043). 4 of 4 patients recovered their kidney function to previous baseline values. There was no association between contrast-induced nephropathy and diuretics, angiotensin-converting enzyme inhibitors, angiotensin II receptor blockers or consumption or levels of calcineurin inhibitors. None of the subjects who were taking mTOR inhibitors developed this nephropathy. Also, no correlation was described in relation to ischemic heart disease, diabetes, peripheral artery disease, baseline creatinine or proteinuria

*Conclusions: With the administered prophylaxis, the incidence of hypoosmolar contrast-induced nephropathy in our population was lower than previously described (6.1%). 100% of acute kidney injuries were reversible. These results suggest that the risk of contrast-induced nephropathy is low in kidney transplant patients, except for those in which renal artery stenosis is suspected or in the ones who take anticalcineurinics and have a higher body mass

To cite this abstract in AMA style:

Jimenez C, Afonso S, Lopez MO, Gonzalez ME, Santana MJ, Santiago A, Vaca MA, Ferreira M, Selgas R. Low Incidence of Acute Renal Failure with Minimal Prophylaxis after Iodinated-Contrast TC in Ambulatory Renal Transplant Patients [abstract]. Am J Transplant. 2019; 19 (suppl 3). https://atcmeetingabstracts.com/abstract/low-incidence-of-acute-renal-failure-with-minimal-prophylaxis-after-iodinated-contrast-tc-in-ambulatory-renal-transplant-patients/. Accessed November 21, 2024.

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