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Purpose <p>This study investigates the risk of contrast-associated acute kidney injury (CA-AKI) in trauma patients, focusing on the impact of cumulative contrast medium doses.</p> Methods <p>A retrospective review was conducted at a level 1 trauma center (2019–2021). The study included patients who underwent intravascular contrast-enhanced examinations for torso trauma within 7 days post-injury. The total contrast medium volume within 7 days was calculated. Multivariate logistic regression (MLR) identified AKI risk factors.</p> Results <p>Among the 264 patients, 7.2% (19/264) developed AKI, with 3.4% (9/264) classified as KDIGO stage 3. Approximately 42.8% of patients underwent at least two contrast-enhanced examinations. The mean total contrast medium given was 129.5mL (range 80-410&#xa0;ml). Multiple logistic regression (MLR) analysis identified four independent risk factors for AKI: diabetes mellitus, initial eGFR &lt; 30, use of inotropic agents, and contrast medium exposure. The odds ratio of AKI increased by 2.92 (95% CI 1.30–6.53) for every 100&#xa0;ml increase in contrast dose. The contrast volume exposure only plays an important role in severe trauma patients (ISS <b>≥</b> 25). Moreover, when correlated with eGFR, the contrast medium exposure volume demonstrated better predictive ability for AKI with a best cut-off value of Contrast volume to eGFR ratio &gt; 1.86.</p> Conclusion <p>While repetitive contrast-enhanced examinations are sometimes inevitable, they do come with costs. The CA-AKI risk increases as the amount of contrast medium accumulates in trauma patients who require repetitive examinations.</p>

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Risk of acute kidney injury following repeated contrast exposure in trauma patients

  • 期刊论文

  • 发表日期：

    2025年1月24日

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  • Yu-Hao Wang,
  • Yu-Tung Wu,
  • Chi-Tung Cheng,
  • Chih-Yuan Fu,
  • Chien-Hung Liao,
  • Huan-Wu Chen,
  • Chi-Hsun Hsieh

摘要

Purpose

This study investigates the risk of contrast-associated acute kidney injury (CA-AKI) in trauma patients, focusing on the impact of cumulative contrast medium doses.

Methods

A retrospective review was conducted at a level 1 trauma center (2019–2021). The study included patients who underwent intravascular contrast-enhanced examinations for torso trauma within 7 days post-injury. The total contrast medium volume within 7 days was calculated. Multivariate logistic regression (MLR) identified AKI risk factors.

Results

Among the 264 patients, 7.2% (19/264) developed AKI, with 3.4% (9/264) classified as KDIGO stage 3. Approximately 42.8% of patients underwent at least two contrast-enhanced examinations. The mean total contrast medium given was 129.5mL (range 80-410 ml). Multiple logistic regression (MLR) analysis identified four independent risk factors for AKI: diabetes mellitus, initial eGFR < 30, use of inotropic agents, and contrast medium exposure. The odds ratio of AKI increased by 2.92 (95% CI 1.30–6.53) for every 100 ml increase in contrast dose. The contrast volume exposure only plays an important role in severe trauma patients (ISS ≥ 25). Moreover, when correlated with eGFR, the contrast medium exposure volume demonstrated better predictive ability for AKI with a best cut-off value of Contrast volume to eGFR ratio > 1.86.

Conclusion

While repetitive contrast-enhanced examinations are sometimes inevitable, they do come with costs. The CA-AKI risk increases as the amount of contrast medium accumulates in trauma patients who require repetitive examinations.