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Kidney Week

Abstract: SA-PO138

Contract Induced Nephropathy in Kidney Transplant Recipients: A Systematic Review and Meta-Analysis

Session Information

Category: Acute Kidney Injury

  • 102 AKI: Clinical, Outcomes, and Trials

Authors

  • Zahid, Umar, Brookdale University Hospital and Medical Center, Brooklyn, New York, United States
  • Hayat, Amir, Brookdale University Hospital and Medical Center, Brooklyn, New York, United States
  • Bedi, Puneet, Brookdale University Hospital and Medical Center, Brooklyn, New York, United States
  • Spitalewitz, Samuel, Brookdale University Hospital and Medical Center, Brooklyn, New York, United States
Background

Kidney transplant recipients (KTR) may be at higher risk of contrast induced Nephropathy (CIN) because of associated risk factors. The incidence proportion of CIN in native kidneys has been reported to be 9% in a recent meta-analysis with 0.5% requiring renal replacement therapy (RRT). We aimed to determine the incidence proportion of CIN in KTR.

Methods

Medline, Embase, and Cochrane databases were used to search the studies assessing the incidence of CIN in KTR from inception until January 2023. We applied Random effect model to estimate the incidence of CIN in KTR.

Results

Sixteen studies, including 805 contrast studies in KTR, were included in the analysis. The estimated incidence of CIN in KTR and CIN requiring RRT was 9.3% (95% confidence interval (CI) 7.1 % to 11.7%) and 1.1% (95% CI: 0.0% to 1.4%), respectively. None of the CIN patients required permanent RRT. In subgroup analysis, the incidence of CIN in KTR who received Iso-osmolar (300 mOsm/kgH20) vs hypo-osmolar CM (550 mOsm/kgH20) was 5.0% (95%CI: 0.8% to 11.2%) and 8.7% (95% CI: 5.6% to 12.2%), respectively. An estimated incidence of CIN in KTR who underwent coronary angiography was 14% (95% CI: 8% to 22%). Angiograms, including allograft renal artery angiograms (without angioplasty/stenting) and CT scans resulted in CIN in 12% (95% CI: 4% to 18%), in 8.6% (95% CI: 5% to 12% CI), respectively. CIN in KTR who underwent angioplasty/stenting to relieve renal artery stenosis (RAS) was 3%. There was complete reversal of CIN with successful therapeutic intervention for RAS, renal function improved above baseline. No graft loss was reported within 30 days post CM administration regardless of the type of CM administered.

Conclusion

The estimated incidence of CIN in KTR is 9.3%, equal to the incidence of CIN in native kidneys (9%). Therefore, it appears that the risk of CIN in KTR patients is not different than the general population.

Forest plot of incidence of CIN in KTR.