Incidence Of Postcontrast Acute Kidney Injury Research Articles

Association of random glucose to albumin ratio with post-contrast acute kidney injury and clinical outcomes in patients with ST-elevation myocardial infarction.

Both glucose and albumin are associated with chronic inflammation, which plays a vital role in post-contrast acute kidney injury (PC-AKI). To explore the relationship between random glucose to albumin ratio (RAR) and the incidence of PC-AKI after percutaneous coronary intervention (PCI) in patients with ST-elevation myocardial infarction (STEMI). STEMI patients who underwent PCI were consecutively enrolled from January, 01, 2010 to February, 28, 2020. All patients were categorized into T1, T2, and T3 groups, respectively, based on RAR value (RAR < 3.377; 3.377 ≤ RAR ≤ 4.579; RAR > 4.579). The primary outcome was the incidence of PC-AKI, and the incidence of major adverse clinical events (MACE) was the second endpoint. The association between RAR and PC-AKI was assessed by multivariable logistic regression analysis. A total of 2,924 patients with STEMI undergoing PCI were finally included. The incidence of PC-AKI increased with the increasing tertile of RAR (3.2% vs 4.8% vs 10.6%, P<0.001). Multivariable regression analysis demonstrated that RAR (as a continuous variable) was associated with the incidence of PC-AKI (adjusted odds ratio (OR) =1.10, 95% confidence interval (CI) =1.04 - 1.16, P<0.001) and in-hospital MACE (OR=1.07, 95% CI=1.02 - 1.14, P=0.012); RAR, as a categorical variable, was significantly associated with PC-AKI (T3 vs. T1, OR=1.70, 95% CI=1.08 - 2.67, P=0.021) and in-hospital MACE (T3 vs. T1, OR=1.63, 95% CI=1.02 - 2.60, P=0.041) in multivariable regression analyses. Receiver operating characteristic curve analysis showed that RAR exhibited a predictive value for PC-AKI (area under the curve (AUC)=0.666, 95% CI=0.625 - 0.708), and in-hospital MACE (AUC= 0.662, 95% CI =0.619 - 0.706). The high value of RAR was significantly associated with the increasing risk of PC-AKI and in-hospital MACE after PCI in STEMI patients, and RAR offers a good predictive value for those outcomes.

Association of random glucose to albumin ratio with post-contrast acute kidney injury and clinical outcomes in patients with ST-elevation myocardial infarction

Abstract Background Both glucose and albumin are associated with chronic inflammation, which plays a vital role in post-contrast acute kidney injury (PC-AKI). However, the relationship between the combination of random glucose and albumin in PC-AKI patients remains elusive. Current study aims to explore the relationship between random glucose to albumin ratio (RAR) and the incidence of PC-AKI after percutaneous coronary intervention (PCI) in patients with ST-elevation myocardial infarction (STEMI). Methods We consecutively enrolled STEMI patients who underwent PCI from January,01 2010 to February,28 2020. All patients were categorized into Q1, Q2, and Q3 groups, respectively, based on RAR value ( RAR&amp;lt;8.62; 8.62≤ RAR ≤ 9 .04; 9.04≤ RAR ≤ 9.45). The primary outcome was the incidence of PC-AKI, which is defined as an increase in serum creatinine (SCr) of more than 44.2 mol/L (0.5 mg/dL) from baseline during the inital 48 to 72 hours after contrast exposure. The incidence of major adverse clinical events (MACE) was the second endpoint, which included all-cause mortality, recurrent of myocardial infarction, renal replacement therapy, stroke, and revascularization of target vessel during hospitalization. The association between RAR and PC-AKI was assessed by multivariate logistic regression analysis. Results A total of 2924 patients with STEMI were finally included. The incidence of PC-AKI increased in a stepwise manner with the increasing tertile of RAR (3.2% vs 4.8% vs 10.6%, P&amp;lt;0.001). Multivariate regression analyses demonstrated that RAR(as a continuous variable) was associated with the incidence of PC-AKI (adjusted odds ratio (OR) =1.10, 95% confdence interval (CI) =1.04–1.16, P=0.000) and in-hospital MACE (OR=1.07, 95% CI=1.02–1.14, P=0.012); When RAR was a categorical variable, RAR was related to PC-AKI (Q3 vs. Q1, OR=1.70, 95% CI=1.08–2.67, P=0.021), and in-hospital MACE (Q3 vs. Q1, OR=1.63, 95% CI=1.02-2.60, P=0.041) when analyzed by multivariate regression analyses. Receiver operating characteristic curve analysis showed that RAR exhibited a predictive value for PC-AKI(area under the curve (AUC)=0.666, 95% CI=0.625-0.708, P&amp;lt;0.001), and in-hospital MACE (AUC= 0.662, 95% CI =0.619 - 0.706) . In addition, the AUC of RAR for predicting PC-AKI in the no diabetes subgroup was significantly higher compared to that in the diabetes subgroup (AUC: 0.640 vs. 0.611, P=0.021). Conclusions The high value of RAR was significantly associated with the incidence of PC-AKI and in-hospital MACE after PCI in STEMI patients, and RAR offers a robust predictive value for these outcomes.Figure 1Figure 2

Electronic alert outpatient protocol improves the quality of care for the risk of postcontrast acute kidney injury following computed tomography.

Prevention and diagnosis of postcontrast acute kidney injury (AKI) after contrast-enhanced computed tomography is burdensome in outpatient department. We investigated whether an electronic alert system could improve prevention and diagnosis of postcontrast AKI. In March 2018, we launched an electronic alert system that automatically identifies patients with a baseline estimated glomerular filtration rate of &lt;45 mL/min/1.73 m2, provides a prescription of fluid regimen, and recommends a follow-up for serum creatinine measurement. Participants prescribed contrast-enhanced computed tomography at outpatient department before and after the launch of the system were categorized as historical and alert group, respectively. Propensity for the surveillance of postcontrast AKI was compared using logistic regression. Risks of AKI, admission, mortality, and renal replacement therapy were analyzed. The historical and alert groups included 289 and 309 participants, respectively. The alert group was more likely to be men and take diuretics. The most frequent volume of prophylactic fluid in historical and alert group was 1,000 and 750 mL, respectively. Follow-up for AKI was more common in the alert group (adjusted odds ratio, 6.00; p &lt; 0.001). Among them, incidence of postcontrast AKI was not statistically different. The two groups did not differ in risks of admission, mortality, or renal replacement therapy. The electronic alert system could assist in the detection of high-risk patients, prevention with reduced fluid volume, and proper diagnosis of postcontrast AKI, while limiting the prescribing clinicians' burden. Whether the system can improve long-term outcomes remains unclear.

Temporal trends of post-contrast acute kidney injury in patients with intravenous administration of iodinated contrast medium

Little is known about whether preventative practices for post-contrast acute kidney injury (PC-AKI) recommended in guidelines have been adopted in clinical practice and translated into a lower incidence of PC-AKI. The aim of this study was to examine the yearly trends in the incidence of PC-AKI, and comorbidities and care practices associated with PC-AKI in hospitalized patients who received intravenous administration of iodinated contrast medium (ICM). Adult patients receiving intravenous ICM at the Second Xiangya Hospital of Central South University in China between 2015 and 2021 were included. Temporal trends in the incidence and risk factors for PC-AKI were evaluated using logistic regression analyses with adjustments for relevant variables. The incidence of PC-AKI has declined significantly from 5.3% in 2015 to 4.1% in 2021 (p < 0.001). This decreasing trend persisted after extensive multivariable adjustments. Of the comorbidities associated with PC-AKI, the proportion of patients with congestive heart failure or hypertension increased, while the proportion of patients older than 75 years, or with an estimated glomerular filtration rate (eGFR) < 30 mL/min/1.73 m2, diabetic nephropathy, or renal stone disease decreased. Among the care practices associated with PC-AKI, the proportion of patients using nephrotoxic drugs decreased, whereas the proportion of patients receiving intravenous fluids > 1000 mL on the day of ICM administration or using iso-osmolar ICM increased. In conclusion, a declining trend in PC-AKI incidence was observed in patients receiving intravenous ICM between 2015 and 2021, which may be related to increased awareness and efforts to prevent PC-AKI.

Post-contrast Acute Kidney Injury After Emergent and Elective Percutaneous Coronary Intervention (from the CREDO-Kyoto PCI/CABG Registry Cohort 3)

Post-contrast acute kidney injury (PC-AKI) is a common complication after percutaneous coronary intervention (PCI). However, it is unclear whether or not the effects of PC-AKI on long-term clinical outcomes were different between emergent and elective procedures. Among patients enrolled in the CREDO-Kyoto PCI/CABG (Coronary Revascularization Demonstrating Outcome Study in Kyoto Percutaneous Coronary Intervention/Coronary Artery Bypass Grafting) registry cohort 3, we identified 10,822 patients treated using PCI (emergent PCI stratum: n=5,022 [46%] and elective PCI stratum: n=5,860 [54%]). PC-AKI was defined as ≥0.3mg/100ml absolute or 1.5-fold relative increase of serum creatinine within 72hours after PCI. The incidence of PC-AKI was significantly higher after emergent PCI than after elective PCI (10.5% vs 3.7%, p <0.001). In the multivariable logistic regression model, emergent PCI was the strongest independent risk factor for PC-AKI in the entire study population. The excess adjusted risk of patients with PC-AKI relative to those without remained significant for all-cause death in both the emergent and elective PCI strata (hazard ratio 1.87, 95% confidence interval 1.59 to 2.21, p <0.001 and hazard ratio 1.31, 95% confidence interval 1.03 to 1.68, p=0.03, respectively). There was a significant interaction between the PCI setting (emergent and elective) and the effect of PC-AKI on all-cause death, with a greater magnitude of effect in the emergent PCI stratum than in the elective PCI stratum (p for interaction=0.01). In conclusion, the incidence of PC-AKI was 2.8 times higher after emergent PCI than after elective PCI. The excess mortality risk of PC-AKI relative to no PC-AKI was greater after emergent PCI than after elective PCI.

Risk factors for post-contrast acute kidney injury in patients sequentially administered iodine- and gadolinium-based contrast media on the same visit to the emergency department: a retrospective study.

This study compares the incidence of post-contrast acute kidney injury (PC-AKI) in patients who received a single administration of iodine-based contrast medium (ICM) with that in patients who received a sequential administration of ICM and gadolinium- based contrast agents (GBCA) in a single visit to an emergency department (ED) to determine the risk factors for PC-AKI. Patients who received one or more contrast media in the ED from 2016 to 2021 were included in this retrospective study. They were divided into the ICM alone and ICM + GBCA groups, and the incidence of PC-AKI was compared between the groups. The risk factors were assessed using a multivariable analysis after propensity score matching (PSM). Overall, 6,318 patients were analyzed, of whom 139 were in the ICM + GBCA group. The incidence of PC-AKI was significantly higher in the ICM + GBCA group than in the ICM alone group (10.9% vs. 27.3%, p &lt; 0.001). In the multivariable analysis, sequential administration was a risk factor for PC-AKI, and single administration was not (adjusted odds ratio [95% confidence interval] in the 1:1, 2:1, and 3:1 PSM cohorts: 2.38 [1.25-4.55], 2.13 [1.26-3.60], and 2.28 [1.39-3.72], respectively). In subgroup analyses of the ICM + GBCA group, osmolality (1.05 [1.01-1.10]) and estimated glomerular filtration rate (eGFR, 0.93 [0.88-0.98]) were associated with PC-AKI. Compared with a single administration of ICM alone, sequential administration of ICM and GBCA during a single ED visit might be a risk factor for PC-AKI. Osmolality and eGFR might be associated with PC-AKI after sequential administration.

Exploring the relationship between post-contrast acute kidney injury and different baseline creatinine standards: A retrospective cohort study.

According to previous studies, the incidence of post-contrast acute kidney injury(PC-AKI) in diabetic is far higher than that in the general population. Therefore, we explored the relationship between the incidence of PC-AKI and different baseline serum creatinine (SCr) levels, and determined the relationship between PC-AKI and different types of contrast media (CMs), different doses of CM, and different examination methods in this specific population. Patients with diabetes in whom CM was used between 2010 and 2020 at our institution were included. Participants were identified according to the following three schemes: Scheme 1 (n=5911), SCr was detected before and within 72h after using CM; Scheme 2 (n=2385), SCr was detected within 24h before and within 24-72 h after using CM; and Scheme 3 (n=81), SCr was detected within 24h before and within 0-24, 24-48, and 48-72 h after using CM. The incidence of PC-AKI with different types of CM, incidence of PC-AKI on digital subtraction angiography (DSA) and enhanced computed tomography (CT), proportion of PC-AKI with different doses of CM, and baseline SCr at different stages of PC-AKI were compared. Multivariate logistic regression analysis was used to explore risk factors for PC-AKI. A total of 29,081 patients were included in this study. The incidence of PC-AKI in Scheme 3 (22.22%) was higher than those in Schemes 1 (6.19%) and 2 (7.71%). The incidence of PC-AKI on DSA was higher than that on enhanced CT (8.30% vs. 5.80%; P<0.05). The incidence of PC-AKI in the increased-dose CM group was higher than that in the non-increased-dose CM group (7.9% vs. 5.7%; P<0.01). Moreover, there were differences in baseline SCr values at different stages of PC-AKI (P<0.01). Multivariate logistic regression analysis showed that hypertension, chronic kidney disease, heart failure, peripheral vascular disease, metformin, diuretics, and CM dose were risk factors for PC-AKI. The incidence of PC-AKI increased significantly with increasing time requirement and frequency of SCr detection. Moreover, before using CM, we should control the blood pressure and heart failure, stop using metformin and diuretics, and use CMs at the minimum dose to avoid PC-AKI.

Predictive Value of Hyperuricemia in Cardiac Patients with Post-Contrast Acute Kidney Injury (PC-AKI) and Different Basic Renal Functions: A Meta-Analysis.

Uric acid level has shown a certain relationship with the incidence of post-contrast acute kidney injury (PC-AKI), whereas it remains controversial whether hyperuricemia can function as a predictor of PCAKI in patients with different basic creatinine serum level. The present meta-analysis aimed to investigate whether hyperuricemia is an independent risk factor for PC-AKI and to explore the relationship between hyperuricemia and basic renal function. Relevant studies were retrieved via searching in PubMed, Embase, Cochrane Library, and WAN FANG electronic databases from inception to Jan 2022. Only studies published in English and Chinese languages were selected. Overall, 11892 patients from 15 studies were included. The results of the pooled analysis revealed that the incidence of PC-AKI was significantly higher in the hyperuricemia group than that in the normouricemic group (20.62% vs. 13.05%). Hyperuricemia was associated with an increased risk of the incidence of PC-AKI (odds ratio (OR): 2.48 [95% confidence interval (CI): 1.77-3.46%]). The pooled ORs for mortality and incidence of undergoing renal replacement therapy were 2.33 (95% CI:1.81-3.00) and 8.69 (95% CI:3.22-23.44%), respectively. Comparatively, the pre-existing renal dysfunction subgroup had a lower relative risk in the hyperuricemia population. Hyperuricemia was found to be significantly associated with the incidence of PC-AKI. The effect of serum uric acid level on the incidence of PC-AKI was higher in patients with normal renal function, which could lay a foundation for the establishment of individualized schemes to prevent PC-AKI by urate-lowering therapy.

Post-Contrast Acute Kidney Injury after Acute Stroke-Insights from a German Tertiary Care Center.

Background: Our aim was to investigate the relationship between additional iodinated contrast medium (CM) application for acute stroke imaging and Post-Contrast Acute Kidney Injury (PC-AKI). Methods: We performed a retrospective analysis of consecutive patients with acute stroke who received a CT angiogram (CTA) with or without additional CT perfusion (CTP) at admission between 2017 and 2020. The primary endpoint was the incidence of PC-AKI. Potential causes of renal function impairment were recorded and logistic regression was performed to determine predictors of PC-AKI. Results: Of 3134 cases screened, n = 989 met the predefined inclusion criteria. PC-AKI occurred in 22 (5.4%) patients who received CTA only and 18 (3.1%) patients who received CTA and additional CTP (unadjusted OR, CI; 0.59, 0.29–1.05). In 31/40 (77.5%) patients who suffered PC-AKI, a non-CM-related cause of renal function impairment was identified. Stroke etiology (hemorrhagic vs. ischemic) and indicators of prior kidney disease were independent predictors of PC-AKI. Conclusions: Additional administration of CM for perfusion imaging in acute stroke did not show a relevant influence on the occurrence of PC-AKI. Patients with intracranial hemorrhage and/or prior kidney disease are at particular risk of developing AKI.

Occurrence and prediction on post-contrast acute kidney injury following endovascular interventions

Objective: To investigate the incidence, risk factors and prognosis of post-contrast acute kidney injury (PC-AKI) and to evaluate the usefulness of serum cystatin C (sCysC) and serum creatinine (sCr) for the prediction of PC-AKI after endovascular interventions. Methods: The clinical data of 404 patients who underwent endovascular procedures from August 2014 to October 2018 in the Sixth People's Hospital South Campus, Shanghai Jiao Tong University were retrospectively analyzed. All patients received 0.9% sodium chloride through an angiographic catheter during the procedure. Patients with an estimated GFR (eGFR)<60 ml/(min·1.73m2) received a continuous intravenous hydration with isotonic saline from 6 hours before to 12 hours after an endovascular procedure. The level of sCr, eGFR and sCysC were measured at 1-2 days pre-procedure and at 48, 72 h, and 7 days post-procedure. Univariate and multivariate logistic regression analyses were used to identify risk factors of PC-AKI. A receiver operator characteristic (ROC) curve was used to evaluate the usefulness of various factors for the prediction of PC-AKI. Kaplan-Meier method was used for survival analysis. Results: Thirteen patients (3.2%) developed PC-AKI. All patients were divided into PC-AKI group and no PC-AKI group for statistical comparison. Wilcoxon signed rank sum test revealed that sCr levels at 7 days post-procedure [63.0 (56.0, 74.0) μmol/L] were significantly lower than pre-procedure sCr levels [65.6 (56.2, 77.0) μmol/L] in patients without PC-AKI (P<0.05). Meanwhile, eGFR levels were significantly higher at 72 h [114.9 (96.3, 135.0) ml/(min·1.73m2)] and 7 days [116.7 (98.5, 139.9) ml/(min·1.73m2)] post-procedure than eGFR levels before endovascular procedures [112.3 (94.1, 133.5) ml/(min·1.73m2)] in patients without PC-AKI (P<0.05). However, there was an increase in sCysC at 48 h [0.9 (0.8, 1.1) mg/L] after endovascular procedures than pre-operative sCysC [0.9 (0.8, 1.1) mg/L] in patients without PC-AKI (P<0.05). SCr, sCysC, levels were significantly increased at 48 h [108.0 (95.3, 125.0) μmol/L, 1.5 (1.2, 2.0) mg/L] and 72 h [123.4 (91.3, 143.0) μmol/L, 1.6 (1.1, 2.0) mg/L] post-procedure than SCr, sCysC, levels before endovascular procedures [81.6 (63.1, 111.0) μmol/L, 1.1 (1.0,1.7) mg/L] and eGFR levels were significantly decreased at 48 h [55.8 (48.9, 77.6) ml/(min·1.73m2)] and 72 h [52.7 (47.7, 63.9) ml/(min·1.73m2)] after endovascular procedures than eGFR levels before exposure to CM [88.8 (65.6, 100.7) ml/(min·1.73m2)] in patients with PC-AKI (P<0.05). SCr, sCysC and eGFR in PC-AKI group tended to levels before an endovascular procedure within 7 days. The receiver operator characteristic curve (ROC) analysis showed that preoperative sCysC and sCr levels had high discriminatory power for evaluating the risk of PC-AKI after an endovascular procedure. ROC analysis showed that sCysC before endovascular procedures was useful to predict the risk of PC-AKI with a satisfactory sensitivity of 69.2% (9/13), specificity of 77.5% (300/387), positive predictive value (PPV) of 9.3% (9/96) and negative predictive value (NPV) of 98.7% (300/304). The incidence of PC-AKI was low in patients with a pre-procedure sCysC<1.09 mg/L. The sCr was predictive of PC-AKI with a satisfactory sensitivity of 69.2% (9/13), specificity of 76.7% (300/391), PPV of 9.0% (9/100) and NPV of 98.7% (300/304). The incidence of PC-AKI was low in patients with a pre-procedure sCr<77.6 μmol/L. Results of univariate analysis and multiple logistic regression analysis indicated that sCysC before endovascular procedures was an risk factor for PC-AKI (OR=13.917, 95%CI:1.666-116.237, P=0.015). The one-year, three-year and five-year survival rate for patients diagnosed with PC-AKI was 50%, 30% and 30% respectively. The median survival time was 6 (0-26) months. Conclusions: The sCysC before endovascular procedures is an independent risk factor of PC-AKI. SCysC and SCr before an endovascular procedure with a cut-off value of 1.09 mg/L and 77.6 μmol/L may help to rule out patients at lower risk of PC-AKI.

Postcontrast Acute Kidney Injury after Peripheral Vascular Interventions in Kidney Transplant Recipients

Postcontrast acute kidney injury (PC-AKI) is a feared complication of peripheral vascular interventions (PVIs), associated with increased mortality. Whether kidney transplant recipients (KTRs) are at increased risk of PC-AKI after PVI is unknown. This study analyzes the perioperative outcomes of KTR following PVI, with emphasis on the incidence and risk factors for PC-AKI. The Vascular Quality Initiative files for PVI (2010-2018) were reviewed. Patients on dialysis were excluded. PC-AKI was defined by Vascular Quality Initiative as creatinine increase ≥0.5mg/dL or new dialysis requirement. Characteristics of KTR and patients without kidney transplant were compared, and propensity score matching used to control for differences in baseline features. Multivariable logistic regression was used to define risk factors for PC-AKI, and survival was compared using Kaplan-Meier analysis. A total of 58,014 procedures were analyzed, including 641 (1%) procedures for KTR. The incidence of PC-AKI in KTR was 2.8% compared with 0.9% in patients without kidney transplants. Baseline warfarin use (odds ratio [OR]=4.7) and poor allograft function (OR=4.0) were significantly associated with increased risk for PC-AKI in KTR. Compared with a matched group of patients without kidney transplant, KTR had similar risk of PC-AKI and were more likely to develop postop myocardial infarction (OR=4.3) but had lower in-hospital mortality (OR=0.22). The incidence of PC-AKI in KTR is higher than the overall population undergoing PVI but is not elevated compared with propensity-matched patients without kidney transplant. PVI for peripheral artery disease in KTR is safe and associated with acceptable perioperative and long-term survival.

Nephrotoxicity of gadolinium-based contrast in the setting of renal artery intervention: retrospective analysis with 10-year follow-up.

We aimed to determine the incidence rate and potential risk factors for postcontrast acute kidney injury (PC-AKI) as well as the long-term clinical implications on dialysis and mortality in patients with chronic kidney disease (CKD) who underwent renal artery stent placement exclusively with gadolinium-based contrast agents. This retrospective study reviewed 412 patients with CKD who underwent renal artery stent placement. Sixty-eight patients underwent intervention exclusively with gadolinium-based contrast agents and were analyzed. Criteria for PC-AKI included either an absolute serum creatinine increase >0.3 mg/dL or percentage increase in serum creatinine >50% within 48 hours of intervention. Logistic regression analysis was performed to identify risk factors for PC-AKI. The cumulative proportion of patients who died or went on to hemodialysis was determined using Kaplan-Meier survival analysis. The incidence of PC-AKI was 14.7%. The rate of AKI decreased for every 1 unit increase in glomerular filtration rate ( GFR, odds ratio [OR]=0.91, P = 0.047). Prehydration was associated with a lower PC-AKI rate (OR=0.17; P = 0.015). Acute kidney injury after intervention was associated with an increased rate of dialysis (Hazard ratio [HR]=4.51, P = 0.002) and mortality (HR=2.52; P = 0.027). Gadolinium-based contrast agents are potentially nephrotoxic when used for endovascular intervention in patients with CKD. The risk of PC-AKI increased with lower GFR and decreased with prehydration. Dialysis and mortality risk were increased in patients who developed PC-AKI.

Risk Predictors for Postcontrast Acute Kidney Injury

ObjectiveTo evaluate risk predictors of acute kidney injury (AKI) after contrast-media procedures in a broader cohort of patients than previously reported. Data SourcesComprehensive medical and pharmacy commercial claims data from 2012 to 2014. Data Collection and Extraction MethodsClaims associated with contrast-media procedures for 2,737,020 persons between January 1, 2012 and November 30, 2014, were reviewed. Principal FindingsThe 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. ConclusionsOverall, 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.