Rate and risk factors for AKI after CT scans in a cancer cohort Journal Article


Authors: Latcha, S.; Plodkowski, A. J.; Zheng, J. T.; Jaimes, E. A.
Article Title: Rate and risk factors for AKI after CT scans in a cancer cohort
Abstract: Aims: The proinflammatory milieu in cancer patients may ex-pose them to increased risk for acute kidney injury (AM) after IV contrast (CON). The aims of this study were to determine: (1) the rates of AKI after CON and noncontrast (NC) CT scans in cancer inpatients, (2) if rates differed among cancer subtypes, and (3) whether recent chemotherapy, comorbid conditions, or nephrotoxins increase AKI after CON. Materials and methods: Retrospective data was collected on adults who had received a CON or NC CT from January 1, 2012 to December 30, 2014. AKI was defined as a > 1.5x increased baseline creatinine. Data was analyzed using Rao-Scott chi(2)-test, propensity score matching, and logistic regressions. Results: A total of 7,512 CT scans were performed in 4,456 patients (4,958 NC, 2,554 CON). The rate for AKI with CON was 7.3% and 11.4% (p < 0.001) with NC imaging. The risk of AM increased with lower baseline eGFR: for eGFR < 29 mL/min/1.73m(2), OR = 1.83 (p = 0.0002); for eGFR 30 - 59 mL/min/1.73m(2). OR = 1.5 compared to eGFR >= 60 mL/min/1.73m(2) (p < 0.0001). AKI rates were higher when any chemotherapy was given within 60 days of CT (OR = 1.22, p < 0.02), with congestive heart failure (OR 1.51, p = 0.0006), and history of AM (OR 3.89, p <0.0001). In 1:1 propensity score matched samples, the OR for AM after CON was 0.87 (p = 0.23) compared to NC. Conclusion: In cancer patients, eGFR below 59 mL/min/1.73m(2) were associated with increased rate of AM, independent of contrast exposure. Congestive heart failure and prior AKI were also associated with increased rates of AKI.
Keywords: nephrotoxicity; risk factors; hypoxia; acute kidney injury; intravenous contrast; acute kidney; contrast-induced nephropathy; contrast nephropathy; injury rate
Journal Title: Clinical Nephrology
Volume: 91
Issue: 3
ISSN: 0301-0430
Publisher: Dustri-Verlag Dr. Karl Feistle  
Date Published: 2019-03-01
Start Page: 147
End Page: 154
Language: English
ACCESSION: WOS:000458630800003
DOI: 10.5414/cn109591
PROVIDER: wos
PUBMED: 30415653
PMCID: PMC6727567
Notes: Article -- Source: Wos
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MSK Authors
  1. Junting Zheng
    150 Zheng
  2. Sheron Latcha
    19 Latcha
  3. Edgar Alberto Jaimes
    33 Jaimes