1288. Incidence of Contrast-Associated Acute Kidney Injury: A Prospective Cohort
Authors * Denotes Presenting Author
  1. André Ribeiro; Hospital de Clínicas de Porto Alegre
  2. Fabricio de Sousa; Hospital de Clínicas de Porto Alegre
  3. Beatriz Juchem; Hospital de Clínicas de Porto Alegre
  4. André Zimerman; Hospital de Clínicas de Porto Alegre
  5. Guilherme Bernardi; Hospital de Clínicas de Porto Alegre
  6. Manoela Vivan; Hospital de Clínicas de Porto Alegre
  7. Tiago Garcia *; Hospital de Clínicas de Porto Alegre
Contrast-associated acute kidney injury (CA-AKI) is a sudden deterioration in renal function that occurs shortly after administration of iodinated contrast medium (ICM). Most studies that defined its existence used older contrast media that was more prone to cause CA-AKI. In the past decade, several articles questioned the true incidence of CA-AKI with newer ICM, which are considered safer. However, there is still a paucity of a data about their safety and the possibility of them leading to AKI. Therefore, the main goal of this work was to assess the incidence of CA-AKI in hospitalized patients who were exposed to computed tomography (CT) with ICM, and to compare with a control group exposed to unenhanced CT.

Materials and Methods:
A prospective cohort with 1003 patients who underwent CT in a tertiary hospital from December 2020 through March 2021 (489 in the control group and 514 in the intervention group) were included. The ICM used was iopimadol, a nonionic monomer, low-osmolar media, with iodine concentration of 300 mg I/mL. All inpatients aged > 18 years who had at least one CT scan during the predefined period were screened for, excluding only patients with missing data, dialysis patients, patients whoi underwent multiple CT scans, patients who had surgery between blood sample collections, and patients who had angiography instead of contrasted CT scan. CA-AKI was defined as a relative increase of serum creatinine of = 50% from baseline, or as an absolute increase of = 0.3 mg/dL, within 18 to 96 hours after the CT. Chi-squared test, Kruskal-Wallis test, and a linear regression model with restricted cubic splines were used for statistical analyses.

Incidence of CA-AKI was 10.1% in the ICM-exposed group and 12.4% in the control group when using the absolute increase criterion. The creatinine variation from baseline was not significantly different between groups. After adjusting for baseline factors, contrast use did not correlate with worsening renal function.

The rate of CA-AKI is very low with newer ICMs, if still existent, and excessive caution regarding contrast use is probably unwarranted.