• Benjamin Khoo, Jan O Friedrich, Gerald Lebovic, Swapnil Hiremath, Guy Fishman, Sara Wing, Alejandro Meraz-Munoz, Ziv Harel, Noam Goder, Amir Gal-Oz, Sean M Bagshaw, and Ron Wald.
• Department of Nephrology, Tan Tock Seng Hospital, Singapore, 11 Jln Tock Seng, 308433, Singapore. Electronic address: benjamin_ze_khoo@ttsh.com.sg.
• J Crit Care. 2025 Jan 30; 87: 155015155015.

BackgroundAcute kidney injury (AKI) is common in hospitalized patients. Administration of iodinated contrast may impede kidney recovery but avoiding contrast may delay diagnosis and therapeutic interventions. There is limited data on the impact of contrast exposure in patients with established AKI receiving renal replacement therapy (RRT).MethodsWe conducted a retrospective cohort study which included all patients with AKI who received RRT at St Michael's Hospital in Toronto, Canada, from January 2007 to December 2022. The exposure was the receipt of iodinated contrast during the 14 days following RRT initiation and while the patient was still RRT-dependent. The primary outcome was RRT dependence at hospital discharge.Results1597 patients with AKI received RRT and 754 patients were included in our analysis. Of these, 185 patients received iodinated contrast. After propensity score weighting, the exposure to contrast was associated with a higher likelihood of RRT dependence at hospital discharge (Odds Ratio 1.73, 95 % confidence interval 1.13-2.53).ConclusionThe receipt of contrast in patients with AKI receiving RRT was associated with an increased risk of RRT dependence at hospital discharge. Contrast exposure in RRT-dependent patients may delay recovery from AKI. The benefits of contrast should be carefully weighed against this risk in patients with AKI receiving RRT.Copyright © 2024. Published by Elsevier Inc.

4 keywords...

hide…