A hospital-based study on risk factors and outcomes of Contrast Induced Acute Kidney Injury (CI-AKI)

Shivendra Singh, Shiv Shankar Sharma, Anupam Agrawal, Prem Shankar Patel, Harish Saini, Partha Pratim Mandal, Khushboo Rani

Abstract


Background: Contrast-induced acute kidney injury (CI-AKI) is one of the most common causes of hospital-acquired AKI. This study was aimed to analyse the incidence of CI-AKI and associated risk factors in hospitalized patients undergoing CT or Catheter related contrast based procedures.
Materials and Methods: This cross-sectional observational study was conducted between September 2016 and August 2018. Hospitalized patients of either sex, aged >18 years scheduled for contrastenhanced computed tomography (CECT), peripheral angiography (PAG), percutaneous transluminal
coronary angioplasty (PTCA), or coronary angiography (CAG), with eGFR >30 were evaluated for CIAKI after excluding other causes of AKI.
Results: A total of 300 patients were enrolled, of which 266 patients completed the study (CECT/PAG, n=138; PTCA/CAG, n=128). The mean age of the patients was 45.85 15.14 years and the majority of patients were males (n=164, 61.6%). The incidence of CI-AKI was 15.6% (n=41). A total of 28.8% of patients with diabetes and 31.1% patients aged >60 years developed CI-AKI. Overall, the increasing contrast volume significantly (p=0.002) increased the incidence of CI-AKI. The incidence of CI-AKI in patients mild renal dysfunction increased significantly (from 5.5% at <50ml to 44% at 150-200 ml) with
the increasing volume of contrast, and was significantly higher (38.8%) in patients with moderate renal dysfunction.
Conclusion: Results showed that radio-contrast related procedure carries a significant risk of nephropathy and patients with diabetes, pre-existing renal dysfunction, and advanced age are at higher risk of CI-AKI.

Keywords: Chronic kidney disease contrast-induced acute kidney injury
contrast media estimated glomerular filtration rate.


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