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Background <p>Since 1930 it has been accepted that intravenous injection of iodinated contrast agent as part of contrast-enhanced computed tomography (CE-CT) imaging can induce a contrast-associated acute kidney injury (CA-AKI). For the last 10 years, studies have investigated this iatrogenia. However, those works didn’t concern patient hospitalised after emergency department (ED) visit. This study assessed the CA-AKI incidence and risk factors in patients hospitalised after a CE-CT in ED.</p> Materials and methods <p>This was a monocentric retrospective study, conducted in a University Hospital ED (Beaujon Hospital) between 2019 and 2022. Patients over 16 years old who received a CE-CT and two serum creatinine dosages, one pre-CT and one post-CT (2 to 7 days later), were included. Risk factors and protective factors of CA-AKI as well as population characteristics were analysed.</p> Results <p>After studying 5079 enhanced CT-scans, 1463 patients fulfilled the inclusion criteria. The incidence of CA-AKI was 4.1%. The associated risk factors were: hypertension (adjusted odds ratio (aOR) = 3.36, 95% confidence interval (CI) (1.76–6.43)), CKD grade 4–5 (aOR = 5.89, 95% CI (1.39–24.95)), waiting time before CT (aOR = 3.36, 95% CI (1.76–6.43)). Ongoing treatment by metformin was found to be a protective factor (aOR = 0.26, 95% CI (0.06–1.12)).</p> Conclusion <p>Our findings suggest that only hypertension and stage 4–5 CKD significantly increase the risk of CA-AKI. Consequently, CT imaging should not be unnecessarily delayed when clinically justified, as prompt diagnosis could help limit morbidity and mortality.</p> Clinical trial number <p>The study was registered at ClinicalTrials.gov on 22 July 2025 (NCT07091656).</p>

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Incidence and risk factors of contrast-associated acute kidney injury in patients hospitalised after contrast-enhanced computed tomography in the emergency department

  • 期刊论文

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  • 发表日期：

    2025年12月29日

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  • Elodie Lecomte,
  • Pradeebane Vaittinada Ayar,
  • Valérie Vilgrain,
  • Prabakar Vaittinada Ayar

摘要

Background

Since 1930 it has been accepted that intravenous injection of iodinated contrast agent as part of contrast-enhanced computed tomography (CE-CT) imaging can induce a contrast-associated acute kidney injury (CA-AKI). For the last 10 years, studies have investigated this iatrogenia. However, those works didn’t concern patient hospitalised after emergency department (ED) visit. This study assessed the CA-AKI incidence and risk factors in patients hospitalised after a CE-CT in ED.

Materials and methods

This was a monocentric retrospective study, conducted in a University Hospital ED (Beaujon Hospital) between 2019 and 2022. Patients over 16 years old who received a CE-CT and two serum creatinine dosages, one pre-CT and one post-CT (2 to 7 days later), were included. Risk factors and protective factors of CA-AKI as well as population characteristics were analysed.

Results

After studying 5079 enhanced CT-scans, 1463 patients fulfilled the inclusion criteria. The incidence of CA-AKI was 4.1%. The associated risk factors were: hypertension (adjusted odds ratio (aOR) = 3.36, 95% confidence interval (CI) (1.76–6.43)), CKD grade 4–5 (aOR = 5.89, 95% CI (1.39–24.95)), waiting time before CT (aOR = 3.36, 95% CI (1.76–6.43)). Ongoing treatment by metformin was found to be a protective factor (aOR = 0.26, 95% CI (0.06–1.12)).

Conclusion

Our findings suggest that only hypertension and stage 4–5 CKD significantly increase the risk of CA-AKI. Consequently, CT imaging should not be unnecessarily delayed when clinically justified, as prompt diagnosis could help limit morbidity and mortality.

Clinical trial number

The study was registered at ClinicalTrials.gov on 22 July 2025 (NCT07091656).