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KMID : 1102220230420030358
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Kidney Research and Clinical Practice
2023 Volume.42 No. 3 p.358 ~ p.369
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Risk factors for post-contrast acute kidney injury in patients sequentially administered iodine- and gadolinium-based contrast media on the same visit to the emergency department: a retrospective study
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Kang Chang-Shin
Han Soo-Hyun
Park Jung-Soo
Choi Dae-Eun
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Abstract
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Background: This study compares the incidence of post-contrast acute kidney injury (PC-AKI) in patients who received a single administration of iodine-based contrast medium (ICM) with that in patients who received a sequential administration of ICM and gadolinium- based contrast agents (GBCA) in a single visit to an emergency department (ED) to determine the risk factors for PC-AKI.
Methods: Patients who received one or more contrast media in the ED from 2016 to 2021 were included in this retrospective study. They were divided into the ICM alone and ICM + GBCA groups, and the incidence of PC-AKI was compared between the groups. The risk factors were assessed using a multivariable analysis after propensity score matching (PSM).
Results: Overall, 6,318 patients were analyzed, of whom 139 were in the ICM + GBCA group. The incidence of PC-AKI was significantly higher in the ICM + GBCA group than in the ICM alone group (10.9% vs. 27.3%, p < 0.001). In the multivariable analysis, sequential administration was a risk factor for PC-AKI, and single administration was not (adjusted odds ratio [95% confidence interval] in the 1:1, 2:1, and 3:1 PSM cohorts: 2.38 [1.25?4.55], 2.13 [1.26?3.60], and 2.28 [1.39?3.72], respectively). In subgroup analyses of the ICM + GBCA group, osmolality (1.05 [1.01?1.10]) and estimated glomerular filtration rate (eGFR, 0.93 [0.88?0.98]) were associated with PC-AKI.
Conclusion: Compared with a single administration of ICM alone, sequential administration of ICM and GBCA during a single ED visit might be a risk factor for PC-AKI. Osmolality and eGFR might be associated with PC-AKI after sequential administration.
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KEYWORD
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Acute kidney injury, Contrast media, Magnetic resonance imaging, X-ray computed tomography
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