MON-227 ARE PATIENTS WITH DIABETES AT GREATER RISK FOR CONTRAST INDUCED NEPHROPATHY THAN THOSE WITHOUT DIABETES?

Abstract

Contrast-induced nephropathy (CIN) is an important cause of acute kidney injury (AKI) in inpatients. However, the prevalence and predisposing factors for CIN remain poorly documented. The aim of this study was to investigate the association between CIN, kidney function and diabetic status in inpatients. We identified inpatients who received IV contrast prior to a computed tomography (CT) scan between July 2012 to March 2018 at Austin Health, Melbourne. Our study was restricted to patients > 54 years as all patients above this age who have a HbA1c measurement when admitted to our hospital as part of the Diabetes Discovery Initiative. Outpatients, patients <54 years, patients who had multiple CT scans with IV contrast and patients with a baseline estimated Glomerular Filtration Rate (eGFR) <30ml/min/1.73m2 were excluded. We obtained creatinine measurements at baseline and 48 hours post contrast administration and defined CIN as an absolute rise in creatinine of ≥44mmol/L. Patients were divided into those with and without a history of diabetes and/or those with renal impairment (defined as an eGFR < or ≥ 60/ml/min/1.73m2). Firth logistic regression model was used for data analysis. Out of 1280 patients, 28.75% had a history of diabetes and 29.53% had baseline eGFR of <60/ml/min/1.73m2 and 70.47% has baseline eGR of ≥60/ml/min/1.73m2. The overall prevalence of CIN was 3.2%. Pre-existing diabetes, degree of glycaemic control (assessed by admission HbA1c) or presence of renal impairment was not associated with an in increased risk of developing CIN. Patients with or without diabetes who had a CT scan with IV contrast appear to have a similar risk for the development of CIN after adjusting for other variables. A larger data set may yield different outcomes.