Assessing the risk of contrast induced-acute kidney injury (CI-AKI) after enhanced CT scan: Single-centre experience.

Abstract

Objective: This study was conducted to assess the risk of contrast-induced AKI (CI-AKI), among Saudi patients who underwent enhanced CT scans at a tertiary care hospital; to understand the incidence and the underlying associated factors of CI-AKI. Methods: We conducted a retrospective review of patients who underwent CT scans with IV contrast from 2016 to 2021, at the King Abdulaziz University Hospital, Jeddah, Saudi Arabia. All authors had no access to information that could identify individual participants during or after data collection. The occurrence of AKI was defined using the “Kidney Disease: Improving Global Outcomes” (KDIGO) consensus definition. The exclusion criteria comprised age <18 years and records with missing key clinical information. Statistical Package for the Social Sciences (SPSS) software, version 21 was used for statistical analysis. The prevalence is presented as a percentage with a 95% confidence level. A P-value <0.05 was considered statistically significant. Results: We reviewed 2000 patient files, of which 1430 met the inclusion criteria. According to the KDIGO definition of AKI, the overall incidence CI-AKI in our study cohort was 8.7%. The incidence of CI-AKI varied across baseline CKD stages, with significantly higher occurrences observed in individuals with CKD Stage5 at 24.3% and Stage4 at 15.9%. Statistical analysis confirmed that the likelihood of CI-AKI is significantly influenced by the baseline eGFR levels. This retrospective analysis found that individuals with hypertension have significantly higher odds of CI-AKI (OR = 2.02, p=0.001) compared to those without hypertension. Moreover, individuals with hyperuricemia have significantly higher odds of CI-AKI (OR = 2.78, p<0.001), compared to those without. The association remains significant after adjusting for other variables (OR = 2.40, p<0.001). The presence of diabetes, malignancy, anaemia, and ischemic heart disease did not show a significant association with CI-AKI. Conclusions: Based on the results of this retrospective study, the overall incidence of CI-AKI is around 8.7 %, among patients undergoing enhanced CT scan. The risk is low and highly influenced by patients’ baseline kidney function. Hypertension and Hyperuricemia are risk factors found to be associated with CI-AKI after enhanced CT scan. Diagnostic and clinically relevant enhanced CT scans should not be deferred based on the potential risk of CI-AKI. Furthermore, pre and peri-scan prevention protocols can significantly mitigate the risk of CI-AKI, even among high-risk patients.