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Incidence of contrast-induced acute kidney injury in a pediatric setting: a cohort study

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Abstract

Background

Contrast-induced acute kidney injury (CI-AKI) is a common pathology among adult patients, with an incidence ranging from 3–25 % depending on risk factors. Little information is available regarding CI-AKI incidence, risk factors, and prognostic impact in the pediatric population.

Methods

We performed a retrospective study of pediatric patients who underwent computed tomography (CT) scan with iodinated contrast media injection between 2005 and 2014 in five pediatric units of a university hospital. CI-AKI was defined according to Kidney Disease/Improving Global Outcomes (KDIGO) criteria.

Results

Of 346 identified patients, 233 had renal function follow-up and were included in our analyses. CI-AKI incidence was 10.3 % [95 % confidence interval (CI) 6.4–14.2 %]. CI-AKI was associated with 30-day unfavorable outcome before (45.8 % vs. 19.7 %, P = 0.007) and after [odds ratio (OR) 3.6; 95 % CI 1.4–9.5] adjustment for confounders. No independent risk factors of CI-AKI were identified.

Conclusions

CI-AKI incidence was as high as 10.3 % following intravenous contrast media administration in the pediatric setting. As reported among adults, CI-AKI was associated with unfavorable outcome after adjustment for confounders. Although additional studies are needed in the pediatric setting, our data suggest that physicians should maintain a high degree of suspicion toward this complication among pediatric patients.

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Author information

Authors and Affiliations

  1. Pediatrics Emergency department, Saint-Etienne University Hospital, Saint-Etienne, France

    Aymeric Cantais & Olivier Mory

  2. Intensive Care Unit, Fattouma Bourguiba Monatir University hospital, Monatir, Tunisia

    Zeineb Hammouda

  3. Pediatrics Intensive Care Unit, Saint-Etienne University Hospital, Saint-Etienne, France

    Hugues Patural

  4. Pediatrics Oncology, Saint-Etienne University Hospital, Saint-Etienne, France

    Jean-Louis Stephan

  5. Pediatrics Radiology Department, Saint-Etienne University Hospital, Saint-Etienne, France

    Lyudmyla Gulyaeva

  6. Medical-Surgical Intensive Care Unit, Saint-Etienne University Hospital, Avenue Albert Raimond, 42270, Saint-Priest-en-Jarez, France

    Michael Darmon

Authors
  1. Aymeric Cantais
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  2. Zeineb Hammouda
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  3. Olivier Mory
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  6. Lyudmyla Gulyaeva
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  7. Michael Darmon
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Corresponding author

Correspondence to Michael Darmon.

Ethics declarations

This study was approved by the institutional review board of the French Society for Intensive Care Medicine (SRLF-CE-14-24). The need for informed consent was waived in accordance with French law. However, patients and family members were informed via a family leaflet and the hospital website’s family information pages that retrospective studies might be performed using patients’ charts.

Conflicts of interest

None.

Financial support

This study was supported by a grant from the French Intensive Care Society (Société de Réanimation de Langue Française).

Electronic supplementary material

Below is the link to the electronic supplementary material.

Figure S1

Contrast-induced acute kidney injury (CI-AKI) according to serum creatinine (CI-AKI creat) or urine output (CI-AKI UO) AKI criteria and unfavorable outcome at day 30 (DOC 40 kb)

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Cantais, A., Hammouda, Z., Mory, O. et al. Incidence of contrast-induced acute kidney injury in a pediatric setting: a cohort study. Pediatr Nephrol 31, 1355–1362 (2016). https://doi.org/10.1007/s00467-016-3313-9

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  • DOI: https://doi.org/10.1007/s00467-016-3313-9

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