(O-I1) Factors Associated with Contrast-induced Acute Kidney Injury in a Tertiary Care Center Emergency Department: An Observational Cohort Study

Objectives: The study aimed to identify the factors associated with the development of CI-AKI in patients presenting to an emergency department (ED) in a low-middle-income country.

Background: Contrast-induced acute kidney injury (CI-AKI) is the third leading cause of hospital-acquired AKI. Assessing serum creatinine levels is routinely used to evaluate kidney function before contrast administration, which might increase ED length of stay and delay patient care.

Methods: This was a retrospective, observational cohort study conducted at the ED of the largest tertiary care center in a low-middle-income country, between November 2018 and December 2019. We included ED patients who have received Computed Tomography (CT) with contrast. The Kidney Disease Improving Global Outcomes (KDIGO) definition for AKI was used as an outcome. Descriptive, bivariate, and logistic regression analyses were used to compare the characteristics of the AKI patients to those who did not develop AKI.

Results: A total of 1832 patients were included in the study, among which 10.4% of patients had developed CI-AKI (n=190). Patients older than 65 were about 1.6 times more associated with CI-AKI (aOR=1.55, p=0.014, 95%CI: 1.09-2.2). Moreover, patients with high blood pressure (≥140 mmHg), high respiratory rate (≥ 22), and chronic kidney disease were significantly more associated with CI-AKI. Additionally, loop diuretic use (aOR=2.21, p< 0.001, 95%CI: 1.49-3.28), beta-lactams use (aOR=4.11, p< 0.001, 95%CI: 2.63-6.42), and allopurinol use (aOR=2.74, p=0.002, 95%CI: 1.43-5.25) were significantly associated with developing CI-AKI.

Conclusions: In an emergency setting assessing factors associated with CI-AKI, such as age, comorbidities, and home medications, can help identify patients with low risk for developing CI-AKI.

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Funding (Optional): This study did not acquire any funding.