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01-12-2011 | Original

Epidemiology of contrast-associated acute kidney injury in ICU patients: a retrospective cohort analysis

Authors: Eric A. J. Hoste, Severine Doom, Jan De Waele, Louke J. Delrue, Luc Defreyne, Dominique D. Benoit, Johan Decruyenaere

Published in: Intensive Care Medicine | Issue 12/2011

Abstract

Purpose

Intensive care unit (ICU) patients frequently undergo contrast-enhanced radiographic examinations, which carries a risk for development of contrast-associated acute kidney injury (CA-AKI). Data on this in ICU patients are scarce. The aim of this study was therefore to evaluate the epidemiology and short- and long-term outcomes of CA-AKI in ICU patients.

Methods

A retrospective single-centre cohort study covering the period 1 March 2004 to 31 December 2008 on ICU patients who underwent a radiography examination with parenteral administration of iodinated radio contrast media was conducted. Data analysis included univariate and multivariate analyses of patients with and without CA-AKI.

Results

A total of 787 ICU patients were included in the study. CA-AKI occurred in 128 (16.3%) and was associated with higher need for RRT [30 (4.6%) vs. 21 (16.4%), p < 0.001], worse kidney function at discharge, longer length of ICU and hospital stay, and higher 28-day and 1-year mortality [28-day: 86 (13.1%) vs. 46 (35.9%), p < 0.001, and 1-year: 158 (24.0%) vs. 71 (55.5%), p < 0.001]. Higher serum creatinine, lower mean arterial pressure, and administration of diuretics and vasoactive therapy were associated with development of CA-AKI in multivariate analysis.

After correction for confounders we found that CA-AKI was associated with 28-day mortality in this cohort of ICU patients (odds ratio = 2.742, 95% confidence interval 1.374–5.471).

Conclusions

CA-AKI occurred in one out of six ICU patients who underwent a contrast-enhanced radiography examination and was associated with both short-and long-term worse outcomes such as need for RRT, worse kidney function at discharge, increased length of stay in the ICU and hospital, and mortality.

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Title: Epidemiology of contrast-associated acute kidney injury in ICU patients: a retrospective cohort analysis
Authors: Eric A. J. Hoste
Severine Doom
Jan De Waele
Louke J. Delrue
Luc Defreyne
Dominique D. Benoit
Johan Decruyenaere
Publication date: 01-12-2011
Publisher: Springer-Verlag
Published in: Intensive Care Medicine / Issue 12/2011
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI: https://doi.org/10.1007/s00134-011-2389-8

At a glance: The STEP trials

Springer Medicine

Epidemiology of contrast-associated acute kidney injury in ICU patients: a retrospective cohort analysis

Abstract

Purpose

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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