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논문분류	춘계학술대회 초록집
제목	Does Contrast-Enhanced CT Accelerate CKD Progression? A Retrospective Analysis in Stage 4 CKD Patients
저자	Seon Min Kim
출판정보	2025; 2025(1):
키워드	Chronic Kidney Disease, Contrast-Enhanced CT, Contrast-Induced Nephropathy
초록	Iodine-based contrast agents can cause adverse reactions such as hypersensitivity and contrast-induced nephropathy(CIN). Although multiple studies have established that the risk of CIN increases with declining renal function, few have examined the long-term effects of contrast-enhanced CT(Contrast CT, CT(CE)) on the progression of chronic kidney disease(CKD). Therefore, this study aimed to determine whether CT(CE) exposure affects CKD progression in patients with Stage 4 CKD. A retrospective analysis was performed on CKD patients who visited the Department of Nephrology between Mar, 2001, and Feb 2024. The estimated glomerular filtration rate(eGFR) was calculated using the 2021 CKD-EPI-Cr equation. Patients whose eGFR declined below 30 mL/min during the observation period were enrolled. Patients with acute kidney injury, prior CRRT, or kidney transplantation are excluded. CKD progression was defined as when two consecutive eGFR declined below 15 mL/min. Patients who underwent CT(CE) from 180 days before the onset of Stage 4 CKD until reaching Stage 5 were classified as the exposure group. In total, 408 patients (mean age, 57.2 years; 58.3% male) were included. Among these patients, 52 were exposed to at least one CT(CE). Except for a history of stroke, there were no differences between the CT(CE)-exposure and non-exposure groups. Following 1:1 propensity score matching, each 49 patients were compared (Table 1). Before matching, CKD Stage 5 progression occurred in 218 non-exposed and 30 exposed patients, with median survival times of 1072 days (95% CI: 938–1336) and 2318 days (95% CI: 2074–3371), respectively (p=0.0057), indicating slower progression in the CT(CE) group. After matching, median survival times were 1309 days (95% CI: 833–NA) for non-exposed and 2247 days (95% CI: 2074–3371) for exposed patients, with no statistically significant difference observed (p=0.38). (Figure 1) In patients with Stage 4 CKD, contrast-enhanced CT exposure was not associated with accelerated progression to Stage 5.
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