Incidence of contrast-induced acute kidney injury in patients with acute mesenteric ischemia and identification of potential predictive factors. (December 2022)

• Record Type: Journal Article
• Authors: Augène, Emmanuel; Lareyre, Fabien; Chikande, Julien; Guidi, Lucas; Mutambayi, Grégoire; Lê, Cong Duy; Jean-Baptiste, Elixène; Katsiki, Niki; Mikhailidis, Dimitri P; Raffort, Juliette
• Is Part Of: Vascular. Volume 30:Number 6(2022)
• Page Start: 1097
• Page End: 1106
• Publication Date: 2022-12
• Subjects: Acute mesenteric ischemia -- contrast-induced nephropathy -- contrast-induced kidney injury -- incidence -- risk factors; 616.13
• DOI: 10.1177/17085381211050766
• Languages: English
• ISSNs: 1708-5381

Abstract

Objective: Contrast-enhanced computed tomography angiography (CTA) is commonly used to investigate acute abdominal conditions, but the risk of contrast-induced acute kidney injury (CI-AKI) has been poorly investigated in patients with acute mesenteric ischemia. The aim of the present study was to evaluate the incidence of CI-AKI in these patients and identify potential predictive factors. Methods: Patients admitted for acute mesenteric ischemia who had a diagnostic CTA with contrast medium and a follow-up of creatinine concentration were retrospectively included. Results: Among 53 patients included, 9 (16.9%) developed CI-AKI. The prevalence of chronic kidney disease did not differ significantly between those who developed CI-AKI and those who did not (33.3 vs 18.2%, p =.372). Plasma total bilirubin and conjugated bilirubin levels were significantly higher in patients who developed CI-AKI (17.5 vs 8.0 μmol/L, p =.013 and 8.0 vs 3.0 μmol/L, p =.031, respectively). The proportion of patients who had revascularization was similar between patients who developed CI-AKI and those who did not (11.1 vs 20.5%, p >.999). No significant difference was observed for 30-day mortality and all-cause mortality for a median follow-up of 168 days (22.2 vs 13.6%, p =.611; and 33.3 vs 61.4%, p =.153, respectively). Conclusion: This study reports the incidence of CI-AKI in patients with acute mesenteric ischemia after diagnostic CTA with contrast medium. Plasma bilirubin levels were a predictive factor of CI-AKI in these patients. The administration of contrast media during revascularization was not associated with an increased risk of CI-AKI.