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Risk of Acute Kidney Injury After Intravenous Contrast Media Administration

Risk of Acute Kidney Injury After Intravenous Contrast Media Administration

The Question

CDDEP Fellow Eili Klein and colleagues studied the relationship between CT contrast media and kidney damage, using emergency department records for a large urban hospital over five years (2009 to 2014). Their analysis included nearly 18,000 patients: 7,200 who had a CT scan with contrast, 5,500 who had a CT scan without contrast, and 5,200 who did not have a CT scan. The study, published in the Annals of Emergency Medicine, found no increase in acute or delayed kidney damage for patients with initial creatinine levels below 4.0 mg/dL(which includes people with some, but not severe, kidney impairment). 

 

Why it matters

The authors caution against changes in practice that could harm patients, however. They write, “It is likely that nephroprotective treatment patterns are at least partially responsible for the observed lack of increased acute kidney injury incidence after contrast media administration.” According to Dr. Klein, the findings bolster the case for randomized trials of contrast media, which have heretofore been considered unethical because of the widely-held belief that contrast media is a definite cause of acute and chronic kidney damage.