English  |  正體中文  |  简体中文  |  Items with full text/Total items : 17776/20117 (88%)
Visitors : 11079773      Online Users : 574
RC Version 7.0 © Powered By DSPACE, MIT. Enhanced by NTU Library IR team.
Scope Tips:
  • please add "double quotation mark" for query phrases to get precise results
  • please goto advance search for comprehansive author search
  • Adv. Search
    HomeLoginUploadHelpAboutAdminister Goto mobile version
    Please use this identifier to cite or link to this item: http://ir.cnu.edu.tw/handle/310902800/32547


    標題: Incidence and risk of dialysis therapy within 30 days after contrast enhanced computed tomography in patients coded with chronic kidney disease: a nation-wide, population-based study
    作者: Shih, Yun-Ju
    Kuo, Yu-Ting
    Chung-Han Ho(何宗翰)
    Chia-Chun Wu(吳佳純)
    Ching-Chung Ko(柯景中)
    貢獻者: Chi Mei Med Ctr, Dept Med Imaging
    Kaohsiung Med Univ Hosp, Dept Med Imaging
    Kaohsiung Med Univ, Coll Med, Fac Med, Dept Radiol
    Chi Mei Med Ctr, Dept Med Res
    Chia Nan Univ Pharm & Sci, Dept Hosp & Hlth Care Adm
    Chi Mei Med Ctr, Dept Internal Med, Div Nephrol
    Chia Nan Univ Pharm & Sci, Dept Pharm
    Chia Nan Univ Pharm & Sci, Ctr Gen Educ
    關鍵字: Chronic kidney disease
    Computed tomography
    Dialysis
    Iodinated contrast media
    日期: 2019-09
    上傳時間: 2020-07-29 13:49:23 (UTC+8)
    出版者: PEERJ INC
    摘要: Background: Patients with chronic kidney disease (CKD) are considered at risk of contrast-induced acute kidney injury and possible subsequent need for dialysis therapy. Computed tomography (CT) is the most commonly performed examination requiring intravenous iodinated contrast media (ICM) injection. The actual risk of dialysis in CKD patients undergoing CT with ICM remains controversial. Furthermore, it is also uncertain whether these at-risk patients can be identified by means of administrative data. Our study is conducted in order to determine the incidence and risk of dialysis within 30 days after undergoing contrast enhanced CT in CKD coded patients. Methods: This longitudinal, nation-wide, populated-based study is carried out by analyzing the Taiwan National Health Insurance Research Database retrospectively. Patients coded under the diagnosis of CKD who underwent CT are identified within randomly selected one million subjects of the database. From January 2012 to December 2013, 487 patients had undergone CT with ICM. A total of 924 patients who underwent CT without ICM are selected as the control group. Patients with advanced CKD or intensive care unit (ICU) admissions are assigned to the subgroups for analysis. The primary outcome is measured by dialysis events within 30 days after undergoing CT scans. The cumulative incidence is assessed by the Kaplan-Meier method and log-rank test. The risk of 30-day dialysis relative to the control group is analyzed by the Cox proportional hazards model after adjusting for age, sex, and baseline comorbidities. Results: The numbers and percentages of dialysis events within 30 days after undergoing CT scans are 20 (4.1%) in the CT with ICM group and 66 (7.1%) in the CT without ICM group (p = 0.03). However, the adjusted hazard ratio (aHR) for 30-day dialysis was 0.84 (95% CI [0.46-1.54], p = 0.57), which is statistically non-significant. In both advanced CKD and ICU admission subgroups, there are also no significant differences in 30-day dialysis risks with the aHR of 1.12 (95% CI [0.38-3.33], p = 0.83) and 0.95 (95% CI [0.44-2.05], p = 0.90), respectively. Conclusions: Within 30 days of receiving contrast-enhanced CT scans, 4.1% of CKD coded patients required dialysis, which appear to be lower compared with subjects who received non-contrast CT scans. However, no statistically significant difference is observed after adjustments are made for other baseline conditions. Thereby, the application of administrative data to identify patients with CKD cannot be viewed as a risk factor for the necessity to undergo dialysis within 30 days of receiving contrast-enhanced CT scans.
    關聯: PEERJ, v.7, e7757
    Appears in Collections:[醫務管理系(所)] 期刊論文
    [藥學系(所)] 期刊論文
    [通識教育中心] 期刊論文

    Files in This Item:

    File Description SizeFormat
    10.7717-peerj.7757.pdf1040KbAdobe PDF83View/Open
    index.html0KbHTML169View/Open


    All items in CNU IR are protected by copyright, with all rights reserved.


    DSpace Software Copyright © 2002-2004  MIT &  Hewlett-Packard  /   Enhanced by   NTU Library IR team Copyright ©   - Feedback