Renal function in cancer patients undergoing repeated administrations of iodinated contrast medium (CM): a multicentric retrospective study

Introduction – Contrast-enhanced computed tomography (CECT) is the imaging of choice for the diagnosis, staging, response evaluation, and follow-up of cancer patients; in fact, 47% of all CECTs are prescribed by Oncologists. Comorbidities, concomitant nephrotoxic (oncological and non-oncological) medications, as well as chronic dehydration from different causes, expose these patients to a higher risk of developing acute kidney injury (AKI) from CM. Risk factors, definition (PC-AKI vs CI-AKI), as well as preventive measures have been recently reconsidered, ultimately downsizing the incidence of this adverse event. Materials and methods – The purpose of this study was to assess the effects of multiple and repeated CM administrations on the renal function in cancer patients on active treatment, collected from 5 Italian oncology departments. We have thus retrospectively evaluated 407 patients, who underwent at least 3 CECT (on the average 3.5) within one year (Table I). Results – According to our study, neither significant differences in eGFR values, calculated with the CKD-EPI formula, between the baseline and the different post-CECT timepoints, nor AKI cases (defined according to the RIFLE criteria), were recorded. Conclusions – Repeated and frequent CM administrations in cancer patients did not lead to a worsening of renal function, confirming that CI-AKI has a significantly lower incidence than previously thought; furthermore, 80% of the patients examined were found to be at low-risk. In concordance with the most recent guidelines, the administration of CM in oncological patients could be freely used, even in patients at higher risk.