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Scans with Intravenous Contrast Agents Seldom Cause Clinically Significant Kidney Injury

By MedImaging staff writers
Posted on 18 Jun 2008

Radiographic procedures such as computed tomography (CT) scans that use intravenous dyes rarely cause clinically significant acute kidney injury in patients with mild baseline kidney disease, according to a recent study.

The study's findings, appearing online in the May 2008 issue of the Clinical Journal of the American Society of Nephrology (CJASN), revealed that these procedures are safe for the large and increasing number of individuals who undergo them as well as give physicians reassuring information on patient risk.

For some CT scans and other procedures used to visualize parts of the internal body, a contrast material such as dye is injected into a blood vessel so that various structures and organs can be seen more easily. Earlier studies have shown that the administration of contrast dye into blood vessels can cause acute kidney injury, or the rapid loss of kidney function due to damage to the kidneys. However, this research has conventionally been conducted in patients undergoing angiographic procedures that are done to detect abnormalities in the blood vessels. Less is known about the risk of acute kidney injury in outpatients who receive intravenous dye for CT scans. These data would be beneficial to physicians, because patients who are considered at risk of kidney injury from these procedures should receive certain preventive interventions.

To fill this gap in knowledge, Dr. Steven Weisbord and his colleagues of the department of Veterans Affairs (VA) Pittsburgh Healthcare System (PA, USA) and the University of Pittsburgh School of Medicine (PA, USA) attempted to determine the incidence of acute kidney injury due to intravenous dye in individuals undergoing CT scans. They conducted a prospective, observational study of 421 patients within the VA Pittsburgh Healthcare System who did not have end-stage renal disease and who were scheduled to undergo CT scans with intravenous dye. They evaluated kidney injury by measuring the amount of creatinine found in the blood. Creatinine is a muscle breakdown product that is filtered by the kidneys; high levels in the blood indicate kidney dysfunction.

In monitoring patients' creatinine levels after the procedures, the researchers reported that only 0.5% of patients had a 50% or more increase in creatinine blood levels, and none had a 100% increase. Contrast-induced acute kidney injury was not uncommon in the subset of patients who were hospitalized or who had advanced kidney impairment before the CT scan. However, kidney injury was very uncommon in outpatients with mild baseline kidney disease. Even when patients did develop contrast-induced acute kidney injury, none required dialysis and none were hospitalized or died because of the kidney disease.

"These observations have important implications for providers ordering and performing computed tomography and for future clinical trials of contrast-induced acute kidney injury in patients undergoing this radiographic procedure,” the authors wrote in their article. They observed that their findings will help clinicians determine which patients are at risk for acute kidney injury and will help make sure that intravenous dye is used in the safest possible manner.

Related Links:
Veterans Affairs Pittsburgh Healthcare System
University of Pittsburgh School of Medicine

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67 (29.087066650391): select jos_linkedin.link from jos_linkedin where cat=10

68 (32.901763916016): SELECT fid FROM jos_deeppockets WHERE id=286240000 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=286240000 AND published='1' LIMIT 1

69 (33.855438232422): SELECT id,name,sponsor_text FROM jos_deeppockets dp left outer join jos_channel_sponsor cs on dp.id=cs.fid WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id=211 ORDER BY `ordering`

70 (378.13186645508): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=286240000 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

71 (252.00843811035): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=286240000 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

72 (54.121017456055): SELECT id,name,title FROM jos_deeppockets WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id != 294743300 AND id != 294743301 AND id != 294743302 AND id != 294743303 AND id != 294743304 AND id != 294743305 AND id != 294743306 AND id != 294743307 AND id != 294743308 AND id != 294743309 AND id != 294743310 AND metakey != 'aacc' ORDER BY `ordering`

73 (53.882598876953): SELECT show_live FROM jos_com_show_setting LIMIT 1

74 (31.948089599609): SELECT show_live FROM jos_com_show_setting LIMIT 1

75 (28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1

76 (28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1

77 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

78 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

79 (28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1

80 (28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1

81 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

82 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

83 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

84 (28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1

85 (28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1

86 (29.087066650391): SELECT show_live FROM jos_com_show_setting LIMIT 1

87 (46.968460083008): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=286240000 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

88 (31.948089599609): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=286240000 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

89 (33.855438232422): SELECT id,name,title FROM jos_deeppockets WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id != 294743300 AND id != 294743301 AND id != 294743302 AND id != 294743303 AND id != 294743304 AND id != 294743305 AND id != 294743306 AND id != 294743307 AND id != 294743308 AND id != 294743309 AND id != 294743310 AND metakey != 'aacc' ORDER BY `ordering`

90 (66.041946411133): SELECT show_live FROM jos_com_show_setting LIMIT 1

91 (41.961669921875): SELECT show_live FROM jos_com_show_setting LIMIT 1

92 (38.14697265625): SELECT show_live FROM jos_com_show_setting LIMIT 1

93 (36.954879760742): SELECT show_live FROM jos_com_show_setting LIMIT 1

94 (60.081481933594): SELECT show_live FROM jos_com_show_setting LIMIT 1

95 (40.054321289062): SELECT show_live FROM jos_com_show_setting LIMIT 1

96 (41.007995605469): SELECT show_live FROM jos_com_show_setting LIMIT 1

97 (39.100646972656): SELECT show_live FROM jos_com_show_setting LIMIT 1

98 (42.200088500977): SELECT show_live FROM jos_com_show_setting LIMIT 1

99 (31.948089599609): SELECT show_live FROM jos_com_show_setting LIMIT 1

100 (28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1

101 (28.848648071289): SELECT show_live FROM jos_com_show_setting LIMIT 1

102 (29.087066650391): SELECT show_live FROM jos_com_show_setting LIMIT 1

103 (41.007995605469): SELECT show_live FROM jos_com_show_setting LIMIT 1

104 (530.00450134277): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=286240000 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=286240000 AND published='1' LIMIT 1

105 (60.081481933594): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=286240000 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=286240000 AND published='1' LIMIT 1

106 (254.15420532227): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=286240000 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

107 (70.095062255859): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=286240000 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

108 (!!!!! 1086.950302124): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=286240000 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=286240000 AND published='1' LIMIT 1

109 (72.956085205078): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=286240000 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=286240000 AND published='1' LIMIT 1

110 (86.069107055664): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.id=286240000 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

111 (!!!!! 1374.9599456787): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.id=286240000 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

112 (619.17304992676): SELECT dp.name, dp.id, dp2.name as channel, ex.name as author_name, ex.specialization, ex.images FROM jos_deeppockets as dp LEFT JOIN jos_experts as ex ON ex.id = dp.author LEFT JOIN jos_deeppockets as dp2 ON dp2.id = dp.fid WHERE dp.author != 0 AND dp.cat = 10 AND dp.published = 1 AND ( (dp.fid = 294743300) OR (dp.fid = 294743301) OR (dp.fid = 294743302) OR (dp.fid = 294743303) OR (dp.fid = 294743304) OR (dp.fid = 294743305) OR (dp.fid = 294743306) OR (dp.fid = 294743307) OR (dp.fid = 294743308) OR (dp.fid = 294743309) OR (dp.fid = 294743310) ) ORDER BY RAND() LIMIT 1

113 (538.11073303223): SELECT dp.name, dp.id, dp2.name as channel, ex.name as author_name, ex.specialization, ex.images FROM jos_deeppockets as dp LEFT JOIN jos_experts as ex ON ex.id = dp.author LEFT JOIN jos_deeppockets as dp2 ON dp2.id = dp.fid WHERE dp.author != 0 AND dp.cat = 10 AND dp.published = 1 AND ( (dp.fid = 294743300) OR (dp.fid = 294743301) OR (dp.fid = 294743302) OR (dp.fid = 294743303) OR (dp.fid = 294743304) OR (dp.fid = 294743305) OR (dp.fid = 294743306) OR (dp.fid = 294743307) OR (dp.fid = 294743308) OR (dp.fid = 294743309) OR (dp.fid = 294743310) ) ORDER BY RAND() LIMIT 1

114 (267.98248291016): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=286240000 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=286240000 AND published='1' LIMIT 1

115 (426.05400085449): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=286240000 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=286240000 AND published='1' LIMIT 1

116 (!!!!! 1755.952835083): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=286240000 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=286240000 AND published='1' LIMIT 1

117 (204.08630371094): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=286240000 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=286240000 AND published='1' LIMIT 1

118 (103.95050048828): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=286240000 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=286240000 AND published='1' LIMIT 1

119 (319.00405883789): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=286240000 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=286240000 AND published='1' LIMIT 1

120 (142.81272888184): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=286240000 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=286240000 AND published='1' LIMIT 1

121 (88.214874267578): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=286240000 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=286240000 AND published='1' LIMIT 1

122 (454.18739318848): SELECT * FROM trending_articles WHERE `journal_id` = 10 AND `timestamp` <= NOW() + INTERVAL 7 DAY ORDER BY `order`

123 (!!!!! 53092.002868652): SELECT * FROM jos_deeppockets WHERE jos_deeppockets.cat = 10 AND jos_deeppockets.type = 'deeppockets_item' AND jos_deeppockets.published = 1 AND jos_deeppockets.created + INTERVAL 14 DAY >= NOW() ORDER BY jos_deeppockets.hits DESC LIMIT 7

124 (547.88589477539): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=286240000 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=286240000 AND type='deeppockets_item' AND published='1' LIMIT 1

125 (!!!!! 15849.828720093): ( SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.video != '' AND dp.video_source != '' AND dp.cat = 10 AND dp.published = 1 AND dp.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) UNION ( SELECT dpa.id, dpa.name, dpa.title, dpa.video, dpa.video_source, dpa.created FROM jos_deeppockets_archive AS dpa WHERE dpa.video != '' AND dpa.video_source != '' AND dpa.cat = 10 AND dpa.published = 1 AND dpa.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) ORDER BY created DESC LIMIT 3

126 (64.849853515625): ( SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.video != '' AND dp.video_source != '' AND dp.cat = 10 AND dp.published = 1 AND dp.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) UNION ( SELECT dpa.id, dpa.name, dpa.title, dpa.video, dpa.video_source, dpa.created FROM jos_deeppockets_archive AS dpa WHERE dpa.video != '' AND dpa.video_source != '' AND dpa.cat = 10 AND dpa.published = 1 AND dpa.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) ORDER BY created DESC LIMIT 3

127 (43.153762817383): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294803337 LIMIT 1

128 (32.901763916016): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294803337 LIMIT 1

129 (45.061111450195): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294803276 LIMIT 1

130 (31.948089599609): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294803276 LIMIT 1

131 (518.798828125): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets_archive AS dp WHERE dp.id = 294803276 LIMIT 1

132 (42.915344238281): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets_archive AS dp WHERE dp.id = 294803276 LIMIT 1

133 (36.001205444336): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294802958 LIMIT 1

134 (30.040740966797): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294802958 LIMIT 1

135 (!!!!! 3518.1045532227): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=286240000 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

136 (576.97296142578): SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=286240000 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

137 (260.82992553711): SELECT name FROM jos_deeppockets WHERE id=211

138 (34.093856811523): SELECT name FROM jos_deeppockets WHERE id=211

139 (777.9598236084): SELECT *, DATE_FORMAT(publish_up,'%d %b %Y') AS date_publish_up, DATE_FORMAT(publish_down,'%d %b %Y') AS date_publish_down FROM jos_events WHERE state=1 AND publish_up > NOW() and extra_info REGEXP '((;)|(^))211((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

140 (698.08959960938): SELECT *, DATE_FORMAT(publish_up,'%d %b %Y') AS date_publish_up, DATE_FORMAT(publish_down,'%d %b %Y') AS date_publish_down FROM jos_events WHERE state=1 AND publish_up > NOW() and extra_info REGEXP '((;)|(^))211((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

141 (451.80320739746): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=286240000 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=286240000 AND published='1' LIMIT 1

142 (336.1701965332): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=286240000 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=286240000 AND published='1' LIMIT 1

143 (!!!!! 15702.962875366): TRUNCATE TABLE jos_trademed_module

144 (708.10317993164): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=286240000 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

145 (!!!!! 2815.9618377686): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=286240000 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

146 (638.96179199219): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=286240000 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

147 (80.108642578125): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=286240000 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

148 (413.89465332031): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=286240000 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=286240000 AND published='1' LIMIT 1

149 (50.067901611328): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=286240000 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=286240000 AND published='1' LIMIT 1

150 (!!!!! 1422.8820800781): SELECT jos_item.* FROM jos_item INNER JOIN jos_number ON jos_item.numberID=jos_number.id WHERE 1=1 AND (jos_item.imgMini<>'') AND jos_item.type='L' AND jos_item.numberID= ( SELECT jos_number.id FROM jos_number WHERE jos_number.journalID IN (10) and jos_number.id in (select distinct jos_number.id from jos_number join jos_item on jos_item.numberid=jos_number.id where jos_item.type='P') ORDER BY (CONVERT(SUBSTRING(issue,1,2),SIGNED) + (CONVERT(SUBSTRING(issue,3,2),SIGNED)*100)) DESC LIMIT 0,1 ) ORDER BY RAND() DESC LIMIT 6

151 (339.03121948242): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=286240000 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=286240000 AND published='1' LIMIT 1

152 (48.87580871582): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=286240000 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=286240000 AND published='1' LIMIT 1

153 (437.02125549316): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=286240000 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=286240000 AND type='deeppockets_item' AND published='1' LIMIT 1

154 (312.80517578125): select distinct links.* from jos_textlinks links join jos_textlinks_placement placement on links.id=placement.link_id where journal_id=(10) and (channel_id=211 or channel_id is null)

155 (41.007995605469): select distinct links.* from jos_textlinks links join jos_textlinks_placement placement on links.id=placement.link_id where journal_id=(10) and (channel_id=211 or channel_id is null)

156 (391.00646972656): SELECT livesite FROM jos_dp_categories WHERE id=10 AND published='1' LIMIT 1

157 (561.95259094238): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=286240000 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=286240000 AND published='1' LIMIT 1

158 (51.975250244141): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=286240000 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=286240000 AND published='1' LIMIT 1

159 (167.1314239502): select jos_twitters.link from jos_twitters where cat=10

160 (190.97328186035): select jos_facebook.link from jos_facebook where cat=10

161 (32.901763916016): select jos_google_plus.link from jos_google_plus where cat=10

162 (29.087066650391): select jos_linkedin.link from jos_linkedin where cat=10

163 (280.85708618164): update jos_bannersmanager_banner set impmade=impmade+1 where id in(14615,14202,14203)

164 (!!!!! 1095.0565338135): insert into jos_banners_delta values (14615,'2025-08-24 17:28:42','216.73.216.171','view'),(14202,'2025-08-24 17:28:42','216.73.216.171','view'),(14203,'2025-08-24 17:28:42','216.73.216.171','view')

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