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Abstract

RÉSUMÉ
OBJECTIFS. La néphropathie aux produits de contraste iodés (NPDCI) est une lésion rénale aigue survenant dans les 48 heures après un examen avec injection de produits de contraste iodé (PDCI). L’objectif de cette étude était de déterminer l’incidence et les facteurs de risque de la NPDCI après la réalisation d’un examen tomodensitométrique (ETDM).
METHODES. Il s’agit d’une étude longitudinale de Décembre 2013 à Mars 2014 qui s’est déroulée dans quatre services de radiologie et d’imagerie de Yaoundé. Etait inclus tout adulte venu réaliser un ETDM avec injection de PDCI ayant bénéficié d’un dosage de la créatininémie avant et 48 heures après l’examen.
RESULTATS. Nous avons recruté 105 patients d’un âge moyen de 52,54±15,21 ans dont 57 (54,3%) femmes. L’hypertension artérielle (22,9%) et l’infection à VIH (15,2%) les étaient principales comorbidités. Les diurétiques (9,9%) et les anti-inflammatoires non stéroïdiens (7,6%) étaient les principaux médicaments utilisés. La créatininémie initiale était élevée chez 7 (6,7%) contre 12 (11,4%) patients 48 heures après. Les scanners cérébral (45,7%) et abdominal (29,5%) étaient les principaux examens réalisés. L’ioxitalamate a été utilisé chez 85 (81%) patients. Dix patients ont présenté une NPDCI, soit une incidence cumulative de 9,5% (IC 2,6-15,6%) en 4 mois et un taux d’incidence de 5 cas pour 100 patients/jour. L’infection par le VIH et les traitements par les aminosides et les produits de la pharmacopée africaine étaient associés à la survenue de la NPDCI.
CONCLUSION. L’incidence de la NPDCI est élevée dans notre milieu. Elle est favorisée par les comorbidités et les médicaments néphrotoxiques.


ABSTRACT
AIM. Contrast-induced nephropathy (CIN) is an acute kidney injury occuring within 48 hours following intravascular administration of contrast medium. The aim of this study was to determine the incidence and risk factors of CIN following computer tomography.
METHODS. This was a cohort study from December 2013 to March 2014 in fourth radiology units of Yaoundé. We included any adult presenting in these units for computed tomography with intravascular administration of contrast medium in whom we performed a serum creatinine dosage before and 48 hours following the exam.
RESULTS. We recruited 105 patients with a mean age of 52.54±15.21 years among which 57 (54.3%) females. Hypertension (22.9%) and HIV infection (15.2%) were the main comorbidities. The diuretics (9.9%) and non-steroidal antiinflammatories drugs (7.6%) were the main drugs used. The serum creatinine was increased in 7 (6.7%) patients before and in 12 (11.4%) patients 48 hours following the exam. The brain (45.7%) and abdominal (29.5%) computer tomographies were the main exams performed. The Ioxitalamate was used in 85 (81%) patients. Ten patients presented a CIN, giving a cumulative incidence of 9.5% (CI 2.6-15.6%) in 4 months and an incidence rate of 5 cases per 100 patients/day. HIV infection and treatment with aminoglycosides and herbal medicines were associated with the occuring of CIN.
CONCLUSION. The incidence of CIN is high in our setting. It’s favoured by comorbidities and the use of nephrotoxic drugs.

 

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Kaze, F. F., Djoko, H., Zeh, O. F., Ama Moor, V. J., & Nko’o Amvene, S. (2015). Incidence et facteurs de risque de la néphropathie aux produits de contrastes iodés après examen tomodensitométrique. HEALTH SCIENCES AND DISEASE, 16(4). https://doi.org/10.5281/hsd.v16i4.567
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