Association between contrast-induced nephrotoxicity and contrast enhanced computed tomography followed by endoscopic retrograde cholangiopancreatography.

Abstract Purpose To determine if endoscopic retrograde cholangiopancreatography (ERCP) performed within 72 hours after contrast enhanced computed tomography (CECT) increases contrast-induced nephrotoxicity (CIN) risk in patients with abdominal complaints. Method This single-center retrospective cohort study included consecutive adult patients with abdominal complaints who underwent CECT between October 1, 2016, and June 30, 2019 at an emergency department (ED). CIN was diagnosed based on serum creatinine (SCr) level >0.5 mg/dL within 72 hours after CECT or that increased >25% compared to pre-CECT level. Logistic regression analysis was performed to determine independent risk factors for CIN, including age, sex, body mass index, comorbidities, medication, pre-CECT SCr level >1.5 mg/dL, and ERCP performed within 72 hours after CECT. For persistent CIN, SCr level was obtained after 3 months at the earliest and compared to data obtained within 72 hours after ERCP and CECT. Results Of 1457 patients with CECT, 90 (6.2%) underwent ERCP within 72 hours after CECT and 93 (6.4%) developed CIN. Multivariate analysis revealed that ERCP performed within 72 hours after CECT (odds ratio, 3.31; 95% confidence interval, 1.74, 6.29; p  1.5 mg/dL (odds ratio, 9.86; 95% confidence interval, 5.08, 19.2; p  Conclusion ERCP performed within 72 hours after CECT and pre-CECT SCr level >1.5 mg/dL are associated with CIN development.