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,
Henry Claireaux,
Caroline English,
Jamie K Frost,
David Henshall,
M Khan,
I Kwek,
Marta Di Nicola,
Shams Ur Rehman,
Sanu Varghese,
T M Drake,
Samira Bell,
Dmitri Nepogodiev,
Kenneth A McLean,
T M Drake,
James C Glasbey,
Aditya Borakati,
T M Drake,
Sivesh K Kamarajah,
Kenneth A McLean,
M F Bath,
Henry Claireaux,
Buket Gundogan,
Midhun Mohan,
Praveena Deekonda,
Chia Yew Kong,
Holly Joyce,
Lisa McNamee,
Evelina Woin,
Joshua Burke,
Chetan Khatri,
J Edward Fitzgerald,
Ewen M Harrison,
Aneel Bhangu,
Dmitri Nepogodiev,
Nishkantha Arulkumaran,
Samira Bell,
Fiona Duthie,
Jeremy Hughes,
Thomas Pinkney,
John R. Prowle,
Toby Richards,
M Thomas,
K Dynes,
M Patel,
Panna Patel,
Catrin Wigley,
Rishi Suresh,
Alexander R. Shaw,
Stefan Klimach,
P Jull,
David A. Evans,
Ryan Preece,
I Ibrahim,
Venughanan Manikavasagar,
Richard Smith,
F S Brown,
Praveena Deekonda,
Ryan Yee Wei Teo,
D P Y Sim,
Aditya Borakati,
Andrew Logan,
Ishani Barai,
H. Amin,
S. Suresh,
Rajiv Sethi,
William Bolton,
O Corbridge,
Laura Horne,
Mark Attalla,
R Morley,
Caitlin Robinson,
Toby Hoskins,
Ross McAllister,
S Lee,
Y Dennis,
G Nixon,
Emily Heywood,
Holly Wilson,
Lauren C. Ng,
Sahan Samaraweera,
Alexandra Mills,
C C Doherty,
Evelina Woin,
Jessica Belchos,
Véronique Phan,
Tarak Chouari,
Thomas W. Gardner,
N Goergen,
John D. Hayes,
Calum Macleod,
Roisin McCormack,
A. McKinley,
Steven McKinstry,
William Milligan,
London Lucien Ooi,
N M Rafiq,
T Sammut,
Elizabeth M. Sinclair,
M. J. Smith,
Clayton J. Baker,
Alex Boulton,
Jorja Collins,
Hannah Charlotte Copley,
Nicola Fearnhead,
Hillary Fox,
Tammy S. Mah,
James McKenna,
Vinci Naruka,
Neha Nigam,
Basil Nourallah,
S. Perera,
A. Qureshi,
Shamit Saggar,
Lianqin Sun,
X Wang,
Donghui Yang,
P Caroll,
Ciarán Doyle,
Satheesh Elangovan,
A Falamarzi,
Kiara Gascon Perai,
E Greenan,
Deepak Jain,
M. Lang-Orsini,
Shujing Jane Lim,
Lisa O’Byrne,
P Ridgway,
Sharon Van Der Laan,
J Wong,
Joshua Arthur,
Jim 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,
Ajit Kishore,
Tiago Martins,
J Philomen,
Roshan 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,
Kasim Ahmad,
Gillian M. Beattie,
M Beatty,
Gill Campbell,
Gordon Donaldson,
Sharon S. Graham,
Da Juanicia 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,
Panna Patel,
L Titu,
Melvinder Basra,
P Gallogly,
Gandra Harinath,
Sharon E Leong,
Akshyaya Pradhan,
Imran Siddiqui,
S.A.J. Zaat,
Ahmed Ali,
Mark Galea,
Wan Limm Looi,
James Ng,
Gary Atkin,
A Azizi,
Zillah Cargill,
Zhou China,
J.M. Elliot,
R Jebakumar,
Justin Lam,
Gagira Mudalige,
C Onyerindu,
M Renju,
V Shankar Babu,
Musarrat Hussain,
Nikita Joji,
Bryony Lovett,
H Mownah,
Baqar Ali,
Ben Cresswell,
Ajit Dhillon,
Y S Dupaguntla,
Chipo Hungwe,
Jack LoweZinola,
J C H Tsang,
K Bevan,
C Cardus,
Anchal Duggal,
Mohammad Sohrab Hossain,
Michael McHugh,
Michael J. Scott,
Fion Sy Chan,
Rhodri Evans,
E Gurung,
Brenda P. Haughey,
B. Jacob-Ramsdale,
Megan Kerr,
J Lee,
Ed McCann,
Kathy M. O’Boyle,
Neil Reid,
Faisal Hayat,
Sarah E Hodgson,
R. A. Johnston,
W. Schuyler Jones,
M Khan,
Thomas Linn,
Samuel Long,
P Seetharam,
Susan Shaman,
Benjamin Smart,
Anilkumar Av,
J. Davies,
Julie Griffith,
Belinda Hughes,
Y Islam,
Debora Kidanu,
N Mushaini,
Iqra Qamar,
Heather A. Robinson,
Martin W. Schramm,
Charlene Tan,
Harry Apperley,
C Billyard,
Jane Blazeby,
Sheila Can,
S Carse,
A. Göpfert,
Angela Loizidou,
J. Parkin,
Emily Sanders,
S. Sharma,
George Slade,
Richard J. Telfer,
I Whybrow Huppatz,
E Worley,
L Chandramoorthy,
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John E. McGillicuddy,
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N Rahunathan,
T Rayne,
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D Zanichelli,
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F S Brown,
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Lauren Crozier,
Jaymie Henry,
Christine M. McCusker,
P Prabakaran,
Rebekah Wilson,
Usama Asif,
Marie Connor,
Shiva Dindyal,
Nikhil Math,
Aalia Pagarkar,
Humaira Saleem,
Ishith Seth,
S. Sharma,
N Standfield,
Timen Swartbol,
Robbie Adamson,
Jaeseok Choi,
Omar El Tokhy,
W Ho,
N R Javaid,
Michael E. Kelly,
A. Mehdi,
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Isabella Plumptre,
Shelby L. Sturrock,
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Oliver Warren,
Emily Crane,
Bill Ferris,
C Gadsby,
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Kevin J. Dunleavy,
Sarah Harris,
Caidong Luo,
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Denis Daly,
L Deery,
E Epanomeritakis,
Megan Harty,
Daniel Kane,
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F Babatunde,
Edem Barnor-Ahiaku,
Gillian M. Beattie,
Praminthra Chitsabesan,
O Dixon,
Nicola Hall,
N Ilenkovan,
Thomas N. MacKrell,
N Nithianandasivam,
Jordan Orr,
Francesco Palazzo,
Mahmoud Saad,
Laura SandlandTaylor,
Julian Sherlock,
Thomas Ashdown,
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Frances M. Smith,
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.