Faculty Collaboration Database

Incidence of Adverse Contrast Reaction Following Nonintravenous Urinary Tract Imaging. Eur Urol Focus 2017 Feb;3(1):89-93

Date

07/20/2017

Pubmed ID

28720373

DOI

10.1016/j.euf.2016.01.009

Scopus ID

2-s2.0-85021817234 (requires institutional sign-in at Scopus site)   10 Citations

Abstract

UNLABELLED: Adverse reactions (ARs) to intravenous (IV) radiographic contrast range from mild urticaria to life-threatening anaphylaxis. Intraluminal contrast dye is routinely used in the urinary tract with a minimal perceived risk of AR. We used the Healthcare Cost and Utilization Project State Inpatient Databases for California and Florida from 2007 to 2011 to identify patients who received urinary tract contrast dye for retrograde pyelography, percutaneous pyelography, retrograde/other cystogram, and ileal conduitogram. After excluding patients who had received IV contrast for other radiologic studies, ARs to contrast were identified by a composite end point of diagnoses not present on admission including shock, anaphylaxis, iatrogenic hypotension, urticaria, angioedema, laryngospasm, laryngeal edema, and/or a new diagnosis of contrast reaction. Overall, 76 174 patients were included who had undergone non-IV urinary tract imaging, 367 (0.48%) of whom developed an AR. On multivariate analysis, receipt of contrast in the lower urinary tract (odds ratio [OR]: 1.8; p=0.04) or upper urinary tract by retrograde pyelography (OR: 1.6; p=0.04) or antegrade pyelography (OR: 2.0; p=0.007) increased the risk of AR compared with control patients. The use of contrast dye in the urinary tract is associated with a low, but present risk of AR.

PATIENT SUMMARY: We looked at patients who underwent a urologic procedure using radiographic contrast media in the urinary tract. Although adverse reactions (ARs) may occur with the use of contrast media in the urinary tract, these reactions are experienced by a minority of patients (approximately 1 in 200). In addition, we found that an allergy to intravenous contrast does not increase a patient's risk of an AR to contrast within the urinary tract.

Author List

Blackwell RH, Kirshenbaum EJ, Zapf MAC, Kothari AN, Kuo PC, Flanigan RC, Gupta GN

Author

Anai N. Kothari MD Assistant Professor in the Surgery department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adult
Aged
Aged, 80 and over
Anaphylaxis
Angioedema
California
Contrast Media
Databases, Factual
Drug-Related Side Effects and Adverse Reactions
Edema
Female
Florida
Humans
Hypotension
Incidence
Laryngismus
Male
Middle Aged
Pulmonary Edema
Shock
Urography