YUNN-FANG HOHsieh K.-L.FAN-LU KUNGFE-LIN LIN WUHsieh L.-L.Chou H.SHYH-JYE CHEN2020-07-072020-07-0720150361-803Xhttps://scholars.lib.ntu.edu.tw/handle/123456789/509178OBJECTIVE. For unknown reasons, there is discordance among previous reports with regard to the association of contrast medium (CM) with nephropathy and the incidence of nephropathy after contrast-enhanced CT. This study aimed to determine the frequency of and possible factors related to CM-induced nephropathy in hospitalized patients, with an emphasis on detailing coprescriptions with nephrotoxic potential. MATERIALS AND METHODS. Of 1378 inpatients who underwent CT, 208 (15.1%) met the inclusion criteria: receipt of IV iodinated CM and baseline serum creatinine level obtained within 45 days before and within 2 weeks after CT. Patient demographics, clinical characteristics, comorbidity, nephrotoxic comedications (nine classes of drugs), and type of CM administered were retrospectively reviewed. Relationships between CM-induced nephropathy (serum creatinine level increase ? 25% or ? 0.5 mg/dL after CT) and risk factors were assessed by stepwise multivariate logistic regression. RESULTS. The cohort of 208 subjects had a high number of comorbidities (mean [± SD], 5.8 ± 3.5 diagnoses) and a high rate of receiving nephrotoxic comedications (45.2%). CM-induced nephropathy was detected in 27 (13.0%) patients. Concurrent use of four nephrotoxic agents (odds ratio [OR], 26.250; 95% CI, 3.673-233.993) was the most influential factor associated with CM-induced nephropathy; other predictors included preexisting renal disease (OR, 8.218; 95% CI, 1.622-42.357), baseline serum creatinine level less than 0.7 or greater than or equal to 1.3 mg/dL (OR, 3.463; 95% CI, 1.341-9.025), and hemoglobin level less than 9.3 g/dL (OR, 3.141; 95% CI, 1.087-8.946). CONCLUSION. Among the known risk factors, such as preexisting renal disease, high serum creatinine level, and low hemoglobin level, a statistically significant association was identified between CM-induced nephropathy and concurrent receipt of four nephrotoxic medications. Relevant preventive measures are warranted for individuals at risk, especially hospitalized patients receiving multiple nephrotoxic medications who require contrast-enhanced CT. ? American Roentgen Ray Society.[SDGs]SDG3creatinine; hemoglobin; iodinated contrast medium; contrast medium; creatinine; adult; Article; clinical feature; cohort analysis; comorbidity; computer assisted tomography; contrast enhancement; contrast induced nephropathy; controlled study; creatinine blood level; demography; disease association; female; follow up; hospital patient; human; major clinical study; male; middle aged; nephrotoxicity; polypharmacy; priority journal; retrospective study; risk assessment; risk factor; adolescent; aged; chemically induced; hospitalization; incidence; Kidney Diseases; risk factor; statistical model; Taiwan; time; very elderly; young adult; Adolescent; Adult; Aged; Aged, 80 and over; Contrast Media; Creatinine; Female; Follow-Up Studies; Hospitalization; Humans; Incidence; Kidney Diseases; Logistic Models; Male; Middle Aged; Polypharmacy; Retrospective Studies; Risk Factors; Taiwan; Time Factors; Tomography, X-Ray Computed; Young Adultjournal article10.2214/AJR.15.14329263973182-s2.0-84943650917