Intravenous contrast use and acute kidney injury: a retrospective study of 1,238 inpatients undergoing computed tomography

• Published in: Radiologia brasileira 2021-04, Vol.54 (2), p.77-82
• Main Authors: Coser, Thyago A, Leitão, Juliana S V, Beltrame, Betina M, Selistre, Luciano S, Tasso, Leandro
• Format: Article
• Language: English
• Subjects: Original; RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING
• ISSN: 0100-3984; 1678-7099; 1678-7099
• DOI: 10.1590/0100-3984.2020.0018

To determine the incidence of nephropathy induced by intravenous contrast in hospitalized patients undergoing computed tomography (CT). This was a retrospective cohort study involving 1,238 patients who underwent CT with or without intravenous administration of a contrast agent (iopromide). The primary outcome measure was acute kidney injury (AKI), as defined by the traditional criteria-an absolute or relative increase in serum creatinine (SCr) ≥ 0.5 mg/dL or ≥ 25% over baseline, respectively, at 2-3 days after contrast administration-and the newer, Kidney Disease: Improving Global Outcomes (KDIGO) criteria-an absolute or relative increase in SCr ≥ 0.3 mg/dL or ≥ 50% over baseline, respectively, at 2-7 days after contrast administration. The overall incidence of AKI was 11.52% when the KDIGO criteria were applied. Univariate logistic regression demonstrated a significant association between an absolute post-CT increase in SCr ≥ 0.5 mg/dL and AKI, although that association did not retain significance in the multivariate analysis. Multivariate logistic regression initially found an association between an absolute post-CT increase in SCr ≥ 0.3 mg/dL and advanced age, although that association was not maintained after correction. We found no association between AKI and the risk factors evaluated. We identified no criteria for contrast-induced nephropathy after CT; nor did we find AKI to be associated with the classical risk factors.