Abstract: SA-PO146
A Risk Prediction Model for Contrast-Associated Acute Kidney Injury (CA-AKI)
Session Information
- Onconephrology: Clinical and Research Advances - II
November 05, 2022 | Location: Exhibit Hall, Orange County Convention Center‚ West Building
Abstract Time: 10:00 AM - 12:00 PM
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 –