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Abstract: SA-PO146

A Risk Prediction Model for Contrast-Associated Acute Kidney Injury (CA-AKI)

Session Information

Category: Onconephrology

  • 1600 Onconephrology

Authors

  • Seitter Pérez, Robert Henry, Brigham and Women's Hospital, Boston, Massachusetts, United States
  • Mu, Yi, Brigham and Women's Hospital Channing Division of Network Medicine, Boston, Massachusetts, United States
  • Rosner, Bernard A., Brigham and Women's Hospital Channing Division of Network Medicine, Boston, Massachusetts, United States
  • Chute, Donald F., Massachusetts General Hospital, Boston, Massachusetts, United States
  • Motwani, Shveta S., Lahey Hospital and Medical Center, Burlington, Massachusetts, United States
  • Curhan, Gary C., Brigham and Women's Hospital Channing Division of Network Medicine, Boston, Massachusetts, United States
  • Gupta, Shruti, Brigham and Women's Hospital, Boston, Massachusetts, United States
Background

Cancer patients undergo frequent CT scans with contrast and may be uniquely predisposed to CA-AKI due to decreased effective circulating volume or concomitant treatment with nephrotoxic chemotherapy. Nevertheless, large-scale data regarding specific risk factors for CA-AKI in this population are lacking.

Methods

We collected data on all CT scans with contrast obtained in adult cancer patients without ESKD from 2016 through 2020 at 2 large cancer centers. With each scan serving as an individual unit, we collected data on demographics, comorbidities, labs, and medications related to each scan. CA-AKI was defined either as a ≥0.3 mg/dl rise in serum creatinine (SCr) from baseline within 48 hours of the CT scan or a 1.5-fold rise in SCr to the peak measurement in the 14 days following the scan. Regression models accounting for correlated data were used to identify risk factors for CA-AKI.

Results

CA-AKI occurred in 2435 of 46,593 scans (5.2%). Non-white race, contrast volume, diabetes mellitus, congestive heart failure, hypoalbuminemia, thrombocytopenia, baseline proteinuria, lower baseline eGFR, and use of diuretics and ACEI/ARBs were each associated with a higher risk of CA-AKI (Table), and the risk of CA-AKI progressively increased with a higher risk score (Figure).

Conclusion

A clinically relevant scoring system is predictive of CA-AKI and can be used to help risk-stratify cancer patients undergoing CT scans with contrast.

Funding

  • Commercial Support