Abstract: SA-PO025

The Risk of Contrast Induced AKI Is Still Present Despite Normal Renal Function

Session Information

Category: Acute Kidney Injury

  • 003 AKI: Clinical and Translational

Authors

  • Chowdhury, Jasarat, Lewisham and Greenwich NHS Trust, London, London, United Kingdom
  • Jain, Seema, Lewisham and Greenwich NHS Trust, London, London, United Kingdom
  • Khan, Masud, Lewisham and Greenwich NHS Trust, London, London, United Kingdom
  • Lee, Jasmine B, Lewisham and Greenwich NHS Trust, London, London, United Kingdom
Background

Iodinated contrast CT studies are a common investigation for patients admitted to hospital. Contrast induced AKI (CI-AKI) is quoted to be the third most common contributor to in hospital AKI with patients with pre-existing CKD, cardiac dysfunction, diabetes and hypertension most at risk. However these studies were done before newer, low osmolality contrast media was common practise.
This study investigates the incidence of contrast induced AKI (CI-AKI) in patients admitted to a UK district general hospital who underwent contrast CT studies.

Methods

All patients who had contrast CT studies over a 2 week period in November 2016 were included in the study. For these studies, 50-100ml of non-ionic, low osmolar contrast agent was injected.
CI-AKI was defined using the KDIGO classification for AKI.

Results

92 patients had contrast CT studies over the time period. Of these patients, 13% had pre-existing CKD, 11% had cardiac dysfunction, 15% had Diabetes and 36% had Hypertension.
5% of patient developed CI-AKI. 4% had stage 1 and 1% had stage 2, no patients had stage 3. However of the 5 patients who developed CI-AKI, none had pre-existing CKD or cardiac dysfunction, 1 had diabetes and 2 had hypertension.

Conclusion

The incidence of CI-AKI in our cohort was lower and less severe than quoted in previous studies which may be due to the lower osmolality contrast agent used.
However, despite risk factors being present in this cohort, none of the patients who developed CI-AKI had pre-existing CKD which is thought to be the most significant risk factor and therefore features most highly in CI-AKI prevention guidelines.
This study suggests that guidance given to prevent CI-AKI should be followed in all patients irrespective of pre-existing risk factors and that having existing CKD should not preclude a contrast study if necessary.