Incidence and risk factors associated with acute kidney injury induced by radiological contrasts in adult patients admitted at KUTH

Abstract

Background: Contrast-induced AKI is an iatrogenic disease caused by intravenous contrast media. Its incidence is reported in some studies to have significantly reduced due to the use of new agents that have low osmolality comparing to the old ones (hypo-osmolar agents). However it is reported in some studies to be on 3rd place among causes of hospital acquired AKI with incidence of 5% among patients who was previously showing normal renal function.This study was done at KUTH with objectives of determining incidence of CI-AKI in hospitalized adult patients, identifying risk factors and generating data on patients who received Intra-venous contrasts. Method: This was a prospective observation Cohort study among hospitalized adult patients who received contrast for imaging purpose. Study population and period The study population included 204 patients who were 18 years old and above, who was hospitalized at KUTH, who received intravenous contrast products for radiological purpose and who accepted to consent for participation in the study and fulfil the inclusion criteria. The study was conducted from 15th February, 2018 to 30th December, 2018. Results This study recruited 204 patients from 5 different departments (Internal medicine, Surgery, Gynaecology-Obstetric, ENT and Emergency). Their mean age was 48.4 ± 18 years. Presumed risk factors were; Diabetes, heart failure, quantity of contrast received, concomitant use of nephrotoxic drugs, age above 65 years, quantity of pre and post contrast IV fluid received. Among all those presumed risk factors, not receiving post contrast IV fluid was associated with risk of CI-AKI, with RR= 8.19 (3.4-19.5), p<0.001. ix The incidence of CI-AKI was found 17.6%, with 7.8 had creatinine rise between 25% - 50% (low to be classified in AKI stage, but fulfil definition of CI-AKI as provided by KDIGO), 6.8% had AKIstage I, 2% AKI stage II and 1% stage III. Conclusion Incidence of CI-AKI is high in our population. This may be due to in part to lack of concise rehydration protocol in patients exposed to contrast.