Radiocontrast has been recognized as a nephrotoxic; however, recent studies conducted on the same found no evidence of nephrotoxicity. Therefore, alternate study designs are required. The objective of this study is to determine whether exposure to intravenous radiocontrast exposure is associated with clinically significant long-term kidney impairment.

This cohort study included a total of 156,028 individuals undergoing D-dimer testing. Researchers used a fuzzy regression discontinuity design. Exposure to intravenous contrast in the form of CTPA was recorded. The main endpoint of the study was estimated glomerular filtration rate (eGFR) up to six months.

The mean baseline eGFR level of participants who underwent the D-dimer test was 86 mL/min/1.73 m2. The results showed that there was no significant association of contrast with eGFR associated with CTPA exposure. Similarly, no association was found between CTPA exposure and the need for kidney replacement therapy, mortality, and acute kidney injury. Subgroup analyses were consistent. Potential harm was reported among patients with diabetes but not among those with other reported risk factors for nephropathy induced by radiocontrast.

The research concluded that while radiocontrast is known to be nephrotoxic, no association was found between the use of radiocontrast and kidney impairment or injury.

Ref: https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/2778363?resultClick=1

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