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01.12.2015 | Research article | Ausgabe 1/2015 Open Access

BMC Anesthesiology 1/2015

Incidence and outcome of contrast-associated acute kidney injury assessed with Risk, Injury, Failure, Loss, and End-stage kidney disease (RIFLE) criteria in critically ill patients of medical and surgical intensive care units: a retrospective study

Zeitschrift:
BMC Anesthesiology > Ausgabe 1/2015
Autoren:
Myoung Hwa Kim, Shin Ok Koh, Eun Jung Kim, Jin Sun Cho, Sung-Won Na
Wichtige Hinweise

Competing interests

The authors declare that they have no competing interests.

Authors’ contributions

MHK made substantial contributions to the design and conduct of the study, analysis of the data, and writing of the manuscript. SWN made substantial contributions to the analysis of the data and writing of the manuscript. SOK made substantial contributions to the study design and conduct of the study. EJK and JSC made substantial contributions to the conduct of the study. All authors have read and approved the final manuscript.

Abstract

Background

Contrast medium used for radiologic tests can decrease renal function. However there have been few studies on contrast-associated acute kidney injury in intensive care unit (ICU) patients. The objective of this study was to evaluate the incidence, characteristics, and outcome of contrast-associated acute kidney injury (CA-AKI) patients using the Risk, Injury, Failure, Loss, and End-stage kidney disease (RIFLE) criteria in critically ill patients in the ICU.

Methods

We conducted a retrospective study of adult patients who underwent contrast-enhanced radiologic tests from January 2011 to December 2012 in a 30-bed medical ICU and a 24-bed surgical ICU.

Results

The study included 335 patients, and the incidence of CA-AKI was 15.5%. The serum creatinine and estimated glomerular filtration rate values in the CA-AKI patients did not recover even at discharge from the hospital compared with the values prior to the contrast use. Among 52 CA-AKI patients, 55.8% (n = 29) had pre-existing kidney injury and 44.2% (n = 23) did not. The CA-AKI patients were divided into risk (31%), injury (31%), and failure (38%) by the RIFLE classification. The percentage of patients in whom AKI progressed to a more severe form (failure, loss, end-stage kidney disease) increased from 38% to 45% during the hospital stay, and the recovery rate of AKI was 17% at the time of hospital discharge. Because the Acute Physiology and Chronic Health Evaluation (APACHE) II score was the only significant variable inducing CA-AKI, higher APACHE II scores were associated with a higher risk of CA-AKI. The ICU and hospital mortality of patients with CA-AKI was significantly higher than in patients without CA-AKI.

Conclusions

CA-AKI is associated with increases in hospital mortality, and can be predicted by the APACHE score.

Trial registration

NCT01807195 on March. 06. 2013.
Literatur
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