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Abstract: TH-PO071

Risk Factors for Post-Contrast AKI in Patients Administered Both Iodine- and Gadolinium-Based Contrast Media on the Same Visit to the Emergency Department

Session Information

Category: Acute Kidney Injury

  • 102 AKI: Clinical‚ Outcomes‚ and Trials

Authors

  • Han, Suyeon, Chungnam National University Hospital, Daejeon, Korea (the Republic of)
  • Ko, Hojoon, Chungnam National University Hospital, Daejeon, Korea (the Republic of)
  • Kim, Moo Jun, Chungnam National University Hospital, Daejeon, Korea (the Republic of)
  • Lee, Eu Jin, Chungnam National University Hospital, Daejeon, Korea (the Republic of)
  • Jeon, Jae wan, Chungnam National University Sejong Hospital, Sejong, Korea (the Republic of)
  • Ham, Youngrok, Chungnam National University, Daejeon, Korea (the Republic of)
  • Choi, Dae Eun, Chungnam National University, Daejeon, Korea (the Republic of)
  • Na, Kiryang, Chungnam National University, Daejeon, Korea (the Republic of)
  • Lee, Kang Wook, Chungnam National University, Daejeon, Korea (the Republic of)
Background

This study aimed to investigate the incidence of post-contrast acute kidney injury (PC-AKI) and its risk factor in patients administered iodine-based contrast media (ICM) alone and mixed use of ICM and gadolinium-based contrast media.

Methods

This retrospective study analyzed the data from 2016 to 2021. Patients who had end-stage of renal disease or missing data for estimating renal function were excluded. The primary outcome was the development of PC-AKI, i.e., an increase in creatinine of ≥25% or 0.5 mg/dL over the baseline or reduction in eGFR of ≥25% within 72 h. We compared the primary outcomes between the ICM alone and Mixed groups using a propensity score matching (PSM) analysis, and its risk factors were assessed from multivariable logistic regression.

Results

Of the 29,635 patients administrated ICM, 6,318 were included. There were 139 patients who mixedly administered ICM and GBCA. Mixed group showed significant higher rate of development of PC-AKI compared with ICM alone group in total cohort (adjusted OR, 3.09 [95% CI, 2.09 – 4.58]) and PSM cohort (adjusted OR, 2.38 [95% CI, 1.25 – 4.55]). On multivariate analysis to investigate risk factors in Mixed group, osmolality (adjusted aOR, 1.05 [95% CI, 1.01–1.10]) and eGFR (adjusted OR, 0.931; 95% CI, 0.883–0.983) were associated with PC-AKI.

Conclusion

Mixed administration of ICM and GBCA on same day at ED visit may be a risk factor for PC-AKI compared with single administration of ICM alone. Osmolality and eGFR may be independently associated with PC-AKI after mixed administration of ICM and GBCA

Funding

  • Government Support – Non-U.S.