Incidence of contrast-induced acute kidney injury in a pediatric setting: a cohort study.

Abstract

Contrast-induced acute kidney injury (CI-AKI) is a common pathology among adult patients, with an incidence ranging from 3-25% depending on risk factors. Little information is available regarding CI-AKI incidence, risk factors, and prognostic impact in the pediatric population. We performed a retrospective study of pediatric patients who underwent computed tomography (CT) scan with iodinated contrast media injection between 2005 and 2014 in five pediatric units of a university hospital. CI-AKI was defined according to Kidney Disease/Improving Global Outcomes (KDIGO) criteria. Of 346 identified patients, 233 had renal function follow-up and were included in our analyses. CI-AKI incidence was 10.3% [95% confidence interval (CI) 6.4-14.2%]. CI-AKI was associated with 30-day unfavorable outcome before (45.8% vs. 19.7%, P = 0.007) and after [odds ratio (OR) 3.6; 95% CI 1.4-9.5] adjustment for confounders. No independent risk factors of CI-AKI were identified. CI-AKI incidence was as high as 10.3% following intravenous contrast media administration in the pediatric setting. As reported among adults, CI-AKI was associated with unfavorable outcome after adjustment for confounders. Although additional studies are needed in the pediatric setting, our data suggest that physicians should maintain a high degree of suspicion toward this complication among pediatric patients.