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

Pediatr Nephrol. 2016 Aug;31(8):1355-62. doi: 10.1007/s00467-016-3313-9. Epub 2016 Mar 21.

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.

Keywords: Acute kidney injury; Contrast-associated nephropathy; Incidence; Pediatrics; Prognosis; Risk factors.

Publication types

  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acute Kidney Injury / chemically induced*
  • Acute Kidney Injury / epidemiology*
  • Adolescent
  • Child
  • Child, Preschool
  • Cohort Studies
  • Contrast Media / adverse effects*
  • Female
  • Humans
  • Incidence
  • Male
  • Retrospective Studies
  • Tomography, X-Ray Computed / methods

Substances

  • Contrast Media