PMID- 30143056 OWN - NLM STAT- MEDLINE DCOM- 20181108 LR - 20181114 IS - 1470-7330 (Electronic) IS - 1740-5025 (Print) IS - 1470-7330 (Linking) VI - 18 IP - 1 DP - 2018 Aug 24 TI - Risk of renal events following intravenous iodinated contrast material administration among inpatients admitted with cancer a retrospective hospital claims analysis. PG - 30 LID - 10.1186/s40644-018-0159-3 [doi] LID - 30 AB - BACKGROUND: There is little published evidence examining the use of contrast material (CM) and the risk of acute renal adverse events (AEs) in individuals with increasingly common risk factors including cancer and chronic kidney disease (CKD). The objective of this study was to use real world hospital data to test the hypothesis that inpatients with cancer having CT procedures with iodinated CM would have higher rates of acute renal AEs in comparison to inpatients without cancer. METHODS: Inpatient hospital visits in the Premier Hospital Database from January 1, 2010 through September 30, 2015 were eligible for inclusion. The outcome of interest was a composite of acute renal AEs including: acute kidney injury, acute renal failure requiring dialysis, contrast induced-acute kidney injury and renal failure. Multivariable models, adjusted for differences in patient demographics and comorbid conditions, were used to estimate the incremental risk of acute renal AEs by CT (with or without iodinated CM), CKD stage and type of cancer. RESULTS: Among 29,850,475 inpatient visits across 611 hospitals, 7.4% had record of a CT scan, 5.9% had CKD, and 3.4% had the primary diagnosis of cancer. The baseline risk for an acute renal AE in patients without cancer or CKD and no CT or CM was 0.5%. The absolute risk increases from baseline by 0.2% with a CT and by 0.8% with iodinated CM. Patients with CKD having a CT scan with iodinated CM have an absolute risk of 4.1 to 9.7% depending on the stage of CKD. For patients with cancer, the absolute risk increases, varying from 0.3 to 2.3% depending on the type of cancer. CONCLUSIONS: Inpatients with cancer are at higher likelihood of developing acute renal AEs following CT with iodinated CM compared to those without a cancer. Understanding the underlying risks of acute renal AEs among complex inpatient admissions is an important consideration in treatment choices for oncology patients. FAU - Ng, Chaan S AU - Ng CS AD - MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX, 77030-4009, USA. FAU - Kalva, Sanjeeva P AU - Kalva SP AD - University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, 75390-8834, TX, USA. FAU - Gunnarsson, Candace AU - Gunnarsson C AUID- ORCID: 0000-0003-0723-585X AD - CTI Clinical Trial & Consulting Services100 E, RiverCenter Blvd, Covington, KY, 41011, USA. cgunnarsson@ctifacts.com. FAU - Ryan, Michael P AU - Ryan MP AD - CTI Clinical Trial & Consulting Services100 E, RiverCenter Blvd, Covington, KY, 41011, USA. FAU - Baker, Erin R AU - Baker ER AD - CTI Clinical Trial & Consulting Services100 E, RiverCenter Blvd, Covington, KY, 41011, USA. FAU - Mehta, Ravindra L AU - Mehta RL AD - University of California San Diego 0892 UCSD Medical Center, 9500 Gilman Drive, La Jolla, CA, 92037, USA. LA - eng PT - Journal Article DEP - 20180824 PL - England TA - Cancer Imaging JT - Cancer imaging : the official publication of the International Cancer Imaging Society JID - 101172931 RN - 0 (Contrast Media) RN - 9679TC07X4 (Iodine) SB - IM MH - Acute Kidney Injury/*epidemiology/etiology MH - Administration, Intravenous MH - Adult MH - Aged MH - Contrast Media/administration & dosage/*adverse effects/chemistry MH - Female MH - Humans MH - Inpatients/statistics & numerical data MH - Insurance Claim Review/*statistics & numerical data MH - Iodine/adverse effects MH - Male MH - Middle Aged MH - Neoplasms/diagnostic imaging/*epidemiology MH - Retrospective Studies MH - Tomography, X-Ray Computed/*adverse effects/methods PMC - PMC6109283 OTO - NOTNLM OT - Acute renal event OT - Cancer OT - Computed tomography OT - Contrast-induced acute kidney injury OT - Contrast-induced nephropathy OT - Iodinated contrast media COIS- ETHICS APPROVAL: All data used to perform this analysis were de-identified and accessed in compliance with the Health Insurance Portability and Accountability Act. As a retrospective analysis of a de-identified database, the research was exempt from Institutional Review Board review under 45 Code of Federal Regulations 46.101(b)(4). CONSENT FOR PUBLICATION: Not applicable. COMPETING INTERESTS: CN has research grant funding from and is a consultant to GE Healthcare. CG, MR, and EB are employees of CTI Clinical Trial & Consulting Services which is a consultant to GE Healthcare. SK has research grant funding from Angiodynamics, Royalties from Springer and Elsevier, is an investor in Althea Healthcare and is a consultant to GE Healthcare and Koo Foundation (Taiwan). RM is a consultant to GE Healthcare. PUBLISHER'S NOTE: Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. EDAT- 2018/08/26 06:00 MHDA- 2018/11/09 06:00 PMCR- 2018/08/24 CRDT- 2018/08/26 06:00 PHST- 2018/04/03 00:00 [received] PHST- 2018/07/21 00:00 [accepted] PHST- 2018/08/26 06:00 [entrez] PHST- 2018/08/26 06:00 [pubmed] PHST- 2018/11/09 06:00 [medline] PHST- 2018/08/24 00:00 [pmc-release] AID - 10.1186/s40644-018-0159-3 [pii] AID - 159 [pii] AID - 10.1186/s40644-018-0159-3 [doi] PST - epublish SO - Cancer Imaging. 2018 Aug 24;18(1):30. doi: 10.1186/s40644-018-0159-3.