Open AccessPerioperative intravenous contrast administration and the incidence of acute kidney injury after major gastrointestinal surgery: prospective, multicentre cohort study
Author(s) -
Kenneth A McLean,
WaheedUlRahman Ahmed,
Melika Akhbari,
H A Claireaux,
C English,
Jamie Frost,
David Henshall,
Muhammad Muntazir Mehdi Khan,
I Kwek,
Marta Di Nicola,
Saad Rehman,
S. Varghese,
T M Drake,
Samira Bell,
Dmitri Nepogodiev,
James Glasbey,
Aditya Borakati,
Sivesh K. Kamarajah,
M F Bath,
Buket Gundogan,
Midhun Mohan,
Praveena Deekonda,
Chia Yew Kong,
Holly Joyce,
Lisa McNamee,
Evelina Woin,
Josh Burke,
Chetan Khatri,
J.E.F. Fitzgerald,
Ewen M. Harrison,
Aneel Bhangu,
Nishkantha Arulkumaran,
Fraser R. Duthie,
Jeremy Hughes,
Thomas Pinkney,
John R. Prowle,
Toby Richards,
M Thomas,
K Dynes,
Mulchand S. Patel,
Prashant Patel,
Catrin Wigley,
Rishi Suresh,
Alexander R. Shaw,
Stefan Klimach,
P Jull,
David A. Evans,
Ryan Preece,
I. Ibrahim,
Venughanan Manikavasagar,
Richard Smith,
Steven R. Brown,
Ryan Yee Wei Teo,
D P Y Sim,
Andrew Logan,
Ishani Barai,
H Amin,
Sandra Suresh,
Rajiv K. Sethi,
William Bolton,
O Corbridge,
L. Horne,
Mark Attalla,
R Morley,
Caitlin Robinson,
Toby Hoskins,
Ross McAllister,
Sanghoon Lee,
Y Dennis,
G Nixon,
Emily G. Heywood,
Holly Wilson,
Lauren C. Ng,
S. Samaraweera,
Alexandra Mills,
Colin P. Doherty,
Jessica Belchos,
Véronique Phan,
Tarak Chouari,
Thomas W. Gardner,
N Goergen,
John Hayes,
Calum Macleod,
Roisin McCormack,
A. McKinley,
Steven McKinstry,
William Milligan,
London Lucien Ooi,
N M Rafiq,
T Sammut,
Elizabeth M. Sinclair,
M Smith,
Clayton Baker,
Alex Boulton,
Jorja Collins,
Hannah C. Copley,
Nicola Fearnhead,
Hillary Fox,
Tammy S. Mah,
James McKenna,
Vinci Naruka,
Neha Nigam,
Basil Nourallah,
S. Perera,
A Qureshi,
Shamit Saggar,
Louise Y. Sun,
X Wang,
Donghui Yang,
P Caroll,
C Doyle,
Satheesh Elangovan,
A Falamarzi,
Kiara Gascon Perai,
Emily Greenan,
D Jain,
Melanie LangOrsini,
Shir Lynn Lim,
Lisa O’Byrne,
Paul F. Ridgway,
Sharon Van Der Laan,
J Wong,
Thomas Arthur,
J Barclay,
PM Bradley,
Claire Edwin,
Emily Finch,
Eri Hayashi,
Marilyn Hopkins,
Deborah Kelly,
Michael E. Kelly,
Neil McCartan,
Alice Ormrod,
A Pakenham,
Jade Hayward,
C. Hitchen,
A. Kishore,
Tiago Martins,
J Philomen,
R Rao,
C. Rickards,
Nancy Burns,
M. Copeland,
Christine M. Durand,
A Dyal,
Ali Ghaffar,
AL Gidwani,
Michael Grant,
C Gribbon,
Almir Adolfo Gruhn,
Martin Leer,
K. Ahmad,
Gillian M. Beattie,
Matthew Beatty,
G Campbell,
Gordon A. Donaldson,
S. Graham,
DaJuanicia N. Holmes,
S. Kanabar,
H Liu,
Cameron McCann,
Richard Stewart,
S. Vara,
O Ajibola-Taylor,
E J E Andah,
Chizobam Ani,
N M O Cabdi,
G Ito,
Mark R. Jones,
A Komoriyama,
L Titu,
Melvinder Basra,
P Gallogly,
G Harinath,
SH Leong,
Akshyaya Pradhan,
Imran Siddiqui,
S.A.J. Zaat,
Ahmed Ali,
Mark Galea,
Wan Limm Looi,
James Ng,
Gary Atkin,
A Azizi,
Zillah Cargill,
Z China,
J.M. Elliot,
R Jebakumar,
Justin Lam,
Gagira Mudalige,
C Onyerindu,
M Renju,
Veena Babu,
P Hussain,
Nikita Joji,
B Lovett,
H Mownah,
B Ali,
Ben Cresswell,
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Y S Dupaguntla,
Chipo Hungwe,
Jack LoweZinola,
J C H Tsang,
K Bevan,
C Cardus,
Anchal Duggal,
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F Chan,
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E Gurung,
Brenda P. Haughey,
B Jacob-Ramsdale,
Megan Kerr,
J Lee,
E McCann,
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Neil Reid,
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Sarah Hodgson,
Richard A. Johnston,
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Thomas Linn,
S. Wesley Long,
P Seetharam,
Susan Shaman,
Benjamin Smart,
A. Anilkumar,
J. Davies,
Julie Griffith,
B Hughes,
Y. Islam,
Debora Kidanu,
N Mushaini,
Iqra Qamar,
Heather A. Robinson,
M. Schramm,
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Harry Apperley,
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Jane Blazeby,
Sheila Can,
S Carse,
A. Göpfert,
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E Worley,
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W Ho,
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Rakesh Patel,
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Omar ElTaji,
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Michelle Mann,
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H Riyat,
H Smith,
C Anandarajah,
M Cipparrone,
Kshitij Desai,
Chuanyu Gao,
Ee Teng Goh,
M Howlader,
Nathan Jeffreys,
Amol Karmarkar,
G Mathew,
Haseeb Mukhtar,
E. Özcan,
Aniruthan Renukanthan,
N Sarens,
Chitta Ranjan Prasad Sinha,
Audie L. Woolley,
Richard Bogle,
O.O. Komolafe,
Florence L. Loo,
Darren Waugh,
Renli Zeng,
Albert V. Crewe,
J. Mathias,
Allison M. Owen,
Albert Prior,
Ila M. Saunders,
Louise Crilly,
J. McKeon,
Harmony Ubhi,
Abideen Idowu Adeogun,
Rebecca Carr,
C. Davison,
S Devalia,
A Hayat,
Rickesh Bharat Karsan,
Caroline Osborne,
C Weegenaar,
Manuk Wijeyaratne,
F Babatunde,
Edem Barnor-Ahiaku,
P. Chitsabesan,
O Dixon,
Nicola Hall,
N Ilenkovan,
T. N. MacKrell,
N Nithianandasivam,
Jordan Orr,
Francesco Palazzo,
Mahmoud Saad,
Laura Sandland-Taylor,
Julian Sherlock,
Thomas Ashdown,
Susan M. Chandler,
T. Garsaa,
J Lloyd,
Siew Yim Loh,
C Perkins,
Anna Powell–Chandler,
Robert G. Underhill
Publication year - 2020
Publication title -
british journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.202
H-Index - 201
eISSN - 1365-2168
pISSN - 0007-1323
DOI - 10.1002/bjs.11453
Subject(s) - medicine , acute kidney injury , perioperative , propensity score matching , prospective cohort study , surgery , odds ratio , incidence (geometry) , anesthesia , physics , optics
Background This study aimed to determine the impact of preoperative exposure to intravenous contrast for CT and the risk of developing postoperative acute kidney injury (AKI) in patients undergoing major gastrointestinal surgery. Methods This prospective, multicentre cohort study included adults undergoing gastrointestinal resection, stoma reversal or liver resection. Both elective and emergency procedures were included. Preoperative exposure to intravenous contrast was defined as exposure to contrast administered for the purposes of CT up to 7 days before surgery. The primary endpoint was the rate of AKI within 7 days. Propensity score‐matched models were adjusted for patient, disease and operative variables. In a sensitivity analysis, a propensity score‐matched model explored the association between preoperative exposure to contrast and AKI in the first 48 h after surgery. Results A total of 5378 patients were included across 173 centres. Overall, 1249 patients (23·2 per cent) received intravenous contrast. The overall rate of AKI within 7 days of surgery was 13·4 per cent (718 of 5378). In the propensity score‐matched model, preoperative exposure to contrast was not associated with AKI within 7 days (odds ratio (OR) 0·95, 95 per cent c.i. 0·73 to 1·21; P = 0·669). The sensitivity analysis showed no association between preoperative contrast administration and AKI within 48 h after operation (OR 1·09, 0·84 to 1·41; P = 0·498). Conclusion There was no association between preoperative intravenous contrast administered for CT up to 7 days before surgery and postoperative AKI. Risk of contrast‐induced nephropathy should not be used as a reason to avoid contrast‐enhanced CT.
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