title: Epidemiology of contrast-associated acute kidney injury in ICU patients: a retrospective cohort analysis.
abstract: OBJECTIVE
  Intensive care unit (ICU) patients frequently undergo contrast-enhanced radiographic examinations, which carries a risk for development of contrast-associated acute kidney injury (CA-AKI). Data on this in ICU patients are scarce. The aim of this study was therefore to evaluate the epidemiology and short- and long-term outcomes of CA-AKI in ICU patients.
  
  
  METHODS
  A retrospective single-centre cohort study covering the period 1 March 2004 to 31 December 2008 on ICU patients who underwent a radiography examination with parenteral administration of iodinated radio contrast media was conducted. Data analysis included univariate and multivariate analyses of patients with and without CA-AKI.
  
  
  RESULTS
  A total of 787 ICU patients were included in the study. CA-AKI occurred in 128 (16.3%) and was associated with higher need for RRT [30 (4.6%) vs. 21 (16.4%), p < 0.001], worse kidney function at discharge, longer length of ICU and hospital stay, and higher 28-day and 1-year mortality [28-day: 86 (13.1%) vs. 46 (35.9%), p < 0.001, and 1-year: 158 (24.0%) vs. 71 (55.5%), p < 0.001]. Higher serum creatinine, lower mean arterial pressure, and administration of diuretics and vasoactive therapy were associated with development of CA-AKI in multivariate analysis.                         After correction for confounders we found that CA-AKI was associated with 28-day mortality in this cohort of ICU patients (odds ratio = 2.742, 95% confidence interval 1.374-5.471).
  
  
  CONCLUSIONS
  CA-AKI occurred in one out of six ICU patients who underwent a contrast-enhanced radiography examination and was associated with both short-and long-term worse outcomes such as need for RRT, worse kidney function at discharge, increased length of stay in the ICU and hospital, and mortality.
authors: Intensive Care Unit, ICU, 2K12 C, Ghent University Hospital, Ghent University, De Pintelaan 185, 9000, Ghent, Belgium. Eric.Hoste@UGent.be
authors: Eric A J
authors: EA
authors: Hoste
authors: Severine
authors: S
authors: Doom
authors: Jan
authors: J
authors: De Waele
authors: Louke J
authors: LJ
authors: Delrue
authors: Luc
authors: L
authors: Defreyne
authors: Dominique D
authors: DD
authors: Benoit
authors: Johan
authors: J
authors: Decruyenaere
mesh_terms: D058186:Acute Kidney Injury / Q000139:chemically induced* / Q000453:epidemiology* / Q000401:mortality; D000368:Aged; D001530:Belgium / Q000453:epidemiology; D003287:Contrast Media / Q000009:adverse effects*; D016208:Databases, Factual; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008485:Medical Audit; D008875:Middle Aged; D012189:Retrospective Studies
chemical_list: D003287:Contrast Media