Cancer surveillance imaging: Does repeated iodinated contrast exposure impact long-term kidney function? Journal Article
| Authors: | Heinen, J.; Hsu, M.; Selby, L. V.; Russo, A. E.; Nash, G. M.; Jaimes, E. A.; Shingarev, R. |
| Article Title: | Cancer surveillance imaging: Does repeated iodinated contrast exposure impact long-term kidney function? |
| Abstract: | Background:, Contrast-induced nephropathy is a well-recognized acute complication in cancer patients, but the long-term effects of repeated contrast exposure are not known. We analyzed the association of the number of contrast-enhanced computed tomography (CECT) examinations and other clinical factors with decline in estimated glomerular filtration rate (eGFR) in colorectal cancer survivors. Materials and methods: We retrospectively queried a prospective surgical colorectal cancer database to identify patients with stage I or II cancer who underwent resection in 2007 - 2013 and were alive for at least 3 years. eGFR was calculated before and 3 years after the surgery with >= 20% decline relative to baseline defined as significant and used as the primary outcome. The association of clinical factors with the primary outcome was analyzed using logistic regression. Results: Only 256 patients with the median follow-up of 65 months had sufficient clinical data for analysis. Median eGFR decline at follow-up was 3.0 InL/min/1.73m2 or 4% change from baseline. 47 patients (18%) had > >= 20% reduction in eGFR, which was not associated with the number of CECT examinations. Multivariable analysis demonstrated that increasing age (OR. 1.03: 95% CI, 1.00 - 1.06), presence of diabetes (OR, 2.33: 95% CI. 1.18 - 4.61), and longer operation time (OR, 1.04; 95% CI, 1.01 - 1.07) were independently associated with a higher likelihood of >= 20% eGFR decline at 3 years. Conclusion: Older age, diabetes, and longer operating time, but not cumulative contrast exposure were found to be associated with worse long-term renal outcomes following surgical resection in patients with early-stage colorectal cancer who survived 3 years. |
| Keywords: | colorectal cancer; risk; chronic kidney disease; progression; injury; computed tomography; surveillance; follow-up; disease; clinical-practice guideline; aortic-aneurysm; contrast-enhanced; renal-function; operative time; contrast-induced nephropathy; onconephrology; post-treatment cancer; aneurysm repair |
| Journal Title: | Clinical Nephrology |
| Volume: | 94 |
| Issue: | 6 |
| ISSN: | 0301-0430 |
| Publisher: | Dustri-Verlag Dr. Karl Feistle |
| Date Published: | 2020-12-01 |
| Start Page: | 281 |
| End Page: | 289 |
| Language: | English |
| ACCESSION: | WOS:000588277700002 |
| DOI: | 10.5414/cn109942 |
| PROVIDER: | wos |
| PUBMED: | 32870145 |
| Notes: | Article -- Source: Wos |
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