Wednesday, April 28, 2021

IV Contrast and Kidney Impairment

REBEL Cast Ep98 - April 28, 2021 - By Salim Rezaie
Paper: Goulden R et al. Association of Intravenous Radiocontrast With Kidney Function: A Regression Discontinuity Analysis. JAMA Intern Med 2021. [Link is HERE]
“Clinical Question: Is intravenous contrast exposure associated with clinically significant long-term kidney impairment?
Author Conclusion:Using a cohort study design and analysis that permits stronger causal interpretation than existing observational research, we found no evidence for a harmful effect on kidney function of intravenous contrast administered for CTPA in an emergency setting.”
Clinical Take Home Point: In this methodologically novel trial, there was no association between IV contrast from CTPA and worsening eGFR up to 6 months after index ED visit. Although a randomized clinical trial would be great, this may be the highest-level evidence we achieve. This trial plus other observational trials on this topic all point to a change in protocols to allow for IV contrast in patients regardless of kidney function.”