Contrast-Induced Nephropathy in Aged Critically Ill Patients

Background. Aging is associated with renal structural changes and functional decline. The attributable risk for renal dysfunction from radiocontrast agents in critically ill older patients has not been well established. Methods. In this prospective study, we assessed the incidence of contrast-induce...

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Main Authors: Eleni Palli, Demosthenes Makris, John Papanikolaou, Grigorios Garoufalis, Epaminondas Zakynthinos
Format: Article
Language:English
Published: Hindawi Limited 2014-01-01
Series:Oxidative Medicine and Cellular Longevity
Online Access:http://dx.doi.org/10.1155/2014/756469
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spelling doaj-5c439611c9054a85b50591eeb3698bab2020-11-24T20:58:12ZengHindawi LimitedOxidative Medicine and Cellular Longevity1942-09001942-09942014-01-01201410.1155/2014/756469756469Contrast-Induced Nephropathy in Aged Critically Ill PatientsEleni Palli0Demosthenes Makris1John Papanikolaou2Grigorios Garoufalis3Epaminondas Zakynthinos4Department of Critical Care, Surgical Department, University Hospital of Larissa, Biopolis, 41110 Larissa, GreeceDepartment of Critical Care, Surgical Department, University Hospital of Larissa, Biopolis, 41110 Larissa, GreeceDepartment of Critical Care, Surgical Department, University Hospital of Larissa, Biopolis, 41110 Larissa, GreeceDepartment of Critical Care, Surgical Department, University Hospital of Larissa, Biopolis, 41110 Larissa, GreeceDepartment of Critical Care, Surgical Department, University Hospital of Larissa, Biopolis, 41110 Larissa, GreeceBackground. Aging is associated with renal structural changes and functional decline. The attributable risk for renal dysfunction from radiocontrast agents in critically ill older patients has not been well established. Methods. In this prospective study, we assessed the incidence of contrast-induced nephropathy (CIN) in critically ill patients with stable renal function who underwent computed tomography with intravenous contrast media. Patients were categorized into two age groups: <65 (YG) or ≥65 years old (OG). CIN was defined as 25% or greater increase from baseline of serum creatinine or as an absolute increase by 0.5 mg/dL until the 5th day after the infusion of contrast agent. We also evaluated the alterations in oxidative stress by assessing serum 8-isoprostane. Results. CIN occurred in 5 of 13 OG patients (38.46%) whereas no YG patient presented CIN (P=0.015). Serum creatinine kinetics in older patients demonstrated a rise over five days following contrast infusion time while a decline was observed in the YG (P=0.005). Conclusions. Older critically ill patients are more prone to develop renal dysfunction after the intravenous infusion of contrast agent in relation to their younger counterparts.http://dx.doi.org/10.1155/2014/756469
collection DOAJ
language English
format Article
sources DOAJ
author Eleni Palli
Demosthenes Makris
John Papanikolaou
Grigorios Garoufalis
Epaminondas Zakynthinos
spellingShingle Eleni Palli
Demosthenes Makris
John Papanikolaou
Grigorios Garoufalis
Epaminondas Zakynthinos
Contrast-Induced Nephropathy in Aged Critically Ill Patients
Oxidative Medicine and Cellular Longevity
author_facet Eleni Palli
Demosthenes Makris
John Papanikolaou
Grigorios Garoufalis
Epaminondas Zakynthinos
author_sort Eleni Palli
title Contrast-Induced Nephropathy in Aged Critically Ill Patients
title_short Contrast-Induced Nephropathy in Aged Critically Ill Patients
title_full Contrast-Induced Nephropathy in Aged Critically Ill Patients
title_fullStr Contrast-Induced Nephropathy in Aged Critically Ill Patients
title_full_unstemmed Contrast-Induced Nephropathy in Aged Critically Ill Patients
title_sort contrast-induced nephropathy in aged critically ill patients
publisher Hindawi Limited
series Oxidative Medicine and Cellular Longevity
issn 1942-0900
1942-0994
publishDate 2014-01-01
description Background. Aging is associated with renal structural changes and functional decline. The attributable risk for renal dysfunction from radiocontrast agents in critically ill older patients has not been well established. Methods. In this prospective study, we assessed the incidence of contrast-induced nephropathy (CIN) in critically ill patients with stable renal function who underwent computed tomography with intravenous contrast media. Patients were categorized into two age groups: <65 (YG) or ≥65 years old (OG). CIN was defined as 25% or greater increase from baseline of serum creatinine or as an absolute increase by 0.5 mg/dL until the 5th day after the infusion of contrast agent. We also evaluated the alterations in oxidative stress by assessing serum 8-isoprostane. Results. CIN occurred in 5 of 13 OG patients (38.46%) whereas no YG patient presented CIN (P=0.015). Serum creatinine kinetics in older patients demonstrated a rise over five days following contrast infusion time while a decline was observed in the YG (P=0.005). Conclusions. Older critically ill patients are more prone to develop renal dysfunction after the intravenous infusion of contrast agent in relation to their younger counterparts.
url http://dx.doi.org/10.1155/2014/756469
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