Risk Predictors for Postcontrast Acute Kidney Injury

J Am Coll Radiol. 2018 Nov;15(11):1547-1552. doi: 10.1016/j.jacr.2018.04.015. Epub 2018 May 22.

Abstract

Objective: To evaluate risk predictors of acute kidney injury (AKI) after contrast-media procedures in a broader cohort of patients than previously reported.

Data sources: Comprehensive medical and pharmacy commercial claims data from 2012 to 2014.

Data collection and extraction methods: Claims associated with contrast-media procedures for 2,737,020 persons between January 1, 2012 and November 30, 2014, were reviewed.

Principal findings: The overall incidence of AKI after a contrast-media procedure was 0.85%. AKI occurred in 26% of cases that had two or more contrast procedures within 30 days, compared with 9% of non-AKI cases. Although the incidence of postcontrast AKI was low, 10% of patients who developed AKI had a recent previous episode of AKI. In cases when AKI had occurred within 180 days of contrast administration, the odds of subsequent kidney injury was 9.39.

Conclusions: Overall, there is a low risk (0.85%) of developing an AKI after a procedure with contrast-media consistent with several recent studies. However, in adults with a recent history of AKI, physicians must consider this history as a risk factor for subsequent AKI.

Keywords: AKI; contrast media; patient safety; quality outcome; risk.

Publication types

  • Observational Study

MeSH terms

  • Acute Kidney Injury / chemically induced*
  • Acute Kidney Injury / epidemiology
  • Adolescent
  • Adult
  • Contrast Media / adverse effects*
  • Female
  • Humans
  • Incidence
  • Insurance Claim Review
  • Male
  • Middle Aged
  • Risk Factors
  • United States / epidemiology

Substances

  • Contrast Media