Risk characteristics and incidence of contrast nephrotoxicity in patients exposed to intravascular contrast at Kenyatta National Hospital.

Abstract

BROAD OBJECTIVE: To determine the incidence and associated risk factors for developing contrast media induced nephropathy in adult patients undergoing intravascularcontrast enhanced imaging procedures at Kenyatta National Hospital. STUDY DESIGN: A prospective/descriptive survey STUDY POPULATION: Adult patients above 13 years of age undergoing intravascular contrast enhanced imaging procedures at the radiology department andcardiac catheterization laboratory at Kenyatta National Hospital. STUDY SETTING: This study was carried out in the departments of radiology and cardiaccatheterization laboratory of Kenyatta National Hospital. METHODOLOGY: Consecutive sampling of 177 patients undergoing contrast enhanced studies was done. Venous blood for serum creatinine sodium, potassium and urea levels determination was drawn at baseline, at 24 and 72 hours after contrast administration. A patient was considered to have developed contrast nephropathy if there were 44.2 umol/l, absolute increases in serum creatinine from the baseline within 72 hours of contrast administration. DATA ANALYSIS: Data was analyzed using SPSS version 15.1 RESULTS: The results of serum creatinine changes at 24 and 72 hours were analyzed against patient's demographic data and known risk factors for contrast nephropathy.Contrast nephropathy was found to occur in 21.3% at 24hrs and 30.7 % at 72 hrs. Cumulative incidence was 32.8%.lt was found to occur in increasing frequency with increase in the number of risk factors, age, amount of contrast and dehydration. CONCLUSION: CIN is common in patients exposed to contrast at KNH CIN is even more common in patients with known risk factors e.g. pre-existing renal insufficiency, eldely, dehydration, and exposure to large volumes of contrast load Riskfor CIN worsens with multiplicity of risk factors. CIN incidence compares with others reported in other studies, inspite of differences in type of procedures most reported