Intravenous Radio-contrast Does Not Harm Kidney Function: JAMA
One of the most important reported harms of radiocontrast administration is acute kidney injury (AKI), an adverse effect known as contrast-induced nephropathy (CIN). However, a recent study suggests that Intravenous contrast is not associated with significant long-term kidney injury. The study findings were published in the JAMA Internal Medicine on April 05, 2021.
Radiocontrast has long been thought of as nephrotoxic; however, a number of recent observational studies found no evidence of an association between intravenous contrast and kidney injury. Because these studies are at high risk of confounding and selection bias, alternative study designs are required to enable a more robust evaluation of this association. Therefore, researchers of Canada conducted a study to determine whether intravenous radiocontrast exposure is associated with clinically significant long-term kidney impairment, using a study design that permits stronger causal interpretation than existing observational research.
In this cohort study, researchers included 156 028 patients of emergency department who have undergone D-dimer testing between 2013 and 2018 in the Canadian province of Alberta. They used a fuzzy regression discontinuity design exploiting the fact that individuals just either side of the eligibility cutoff for a computed tomographic pulmonary angiogram (CTPA)—typically 500 ng/mL—have markedly different probabilities of contrast exposure, but should otherwise be similar to potential confounders. The major outcome assessed was estimated glomerular filtration rate (eGFR) up to 6 months following the index emergency department visit.
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