Contrast-Induced Acute Kidney Injury (CIAKI) Following Computed Tomography
The intravascular (IV) administration of iodinated contrast media is a well-recognized cause of acute kidney injury, which is associated with in-hospital morbidity and mortality. Most studies of contrast-induced acute kidney injury (CIAKI) have focused on patients undergoing angiographic procedures. This study sought to assess the incidence and outcomes of CIAKI in veterans undergoing non-emergent, contrast-enhanced computed tomography in the inpatient and outpatient setting. Investigators identified 421 veterans (70% outpatient, 30% inpatient) who underwent non-emergent computed tomography with IV contrast at one VA Medical Center between 2/05 and 7/06, and whose primary risk factor for acute kidney injury was the administration of IV contrast. Serum creatinine levels (used in diagnosing kidney injury) were assessed 48-96 hours post-procedure to evaluate the incidence of CIAKI. Overall, findings show that the incidence of CIAKI varied from 0% to 6.5% based on relative increases in serum creatinine. CIAKI was not associated with need for post-procedure dialysis, hospital admission, or 30-day mortality. Clinically significant CIAKI following non-emergent computed tomography is very uncommon among outpatients with mild kidney disease. These findings have important implications for providers ordering and performing computed tomography, and for future clinical trials of CIAKI.
Weisbord S, Mor M, Resnick A, Hartwig K, Palevsky P, and Fine M. Incidence and Outcomes of Contrast-Induced AKI Following Computed Tomography. Clinical Journal of the American Society of Nephrology September 2008;3(5):1274-81.
This study was partly supported through Dr. Weisbord’s HSR&D Research Career Development award. Except for Dr. Palevsky, all authors are part of HSR&D’s Center for Health Equity Research and Promotion, Pittsburgh, PA.