PLoS ONE (Jan 2015)

Use of cystatin C and serum creatinine for the diagnosis of contrast-induced nephropathy in patients undergoing contrast-enhanced computed tomography at an oncology centre.

  • Joao Italo Fortalesa Melo,
  • Rubens Chojniak,
  • Debora Helena Costa Silva,
  • Jose Carlos Oliveira Junior,
  • Almir Galvão Vieira Bitencourt,
  • Diego Holanda Silva,
  • Marcos Duarte Guimarães,
  • Hernandes Cerqueira Souza Silva,
  • Denis Guilherme Teixeira Dias,
  • Winglison Carli Rodrigues,
  • Ellen Luzia Brancucci,
  • Barbara Martins Soares Cruz,
  • Beatriz Nunes Schiavon,
  • Juliana Luz Passos Argenton,
  • Margareth Arrivabene Camporini,
  • Adriana Zocchio

DOI
https://doi.org/10.1371/journal.pone.0122877
Journal volume & issue
Vol. 10, no. 5
p. e0122877

Abstract

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ObjectiveOur aim was to assess renal function using as laboratory measurements serum creatinine and cystatin C concentrations before and after administration of low-osmolarity (nonionic) iodinated contrast medium in patients with cancer undergoing computed tomography (CT).MethodsThis prospective study included 400 oncologic outpatients. Serum creatinine and cystatin C concentrations were measured before and 72 h after contrast administration. Glomerular filtration rates (GFRs) were estimated using serum creatinine-based [Modification of Diet in Renal Disease (MDRD) and Cockroft-Gault and cystatin C based (Larsson) equations. Exploratory data analysis was performed. The nonparametric Wilcoxon test was used to compare pre and post contrast of test results and estimated clearance. The confidence interval used in the analysis was 95%.ResultsCompared with the pre-contrast values, the mean serum creatinine concentration was significantly higher and average GFRs estimated using MDRD and Cockcroft-Gault equations were significantly lower after the administration of contrast (p ConclusionsAssessment using serum creatinine and cystatin C concentrations showed changes in renal function among patients with cancer undergoing contrast-enhanced CT examination in this study. No significant renal damage related to the use of low-osmolarity iodinated contrast medium of the type and dosage employed in this study was observed. This contrast medium is thus safe for use in patients with cancer.