title: Incidence and Risk Factors for Postcontrast Acute Kidney Injury in Survivors of Sudden Cardiac Arrest.
abstract: OBJECTIVE
  Survivors of sudden cardiac arrest may be exposed to iodinated contrast from invasive coronary angiography or contrast-enhanced computed tomography, although the effects on incident acute kidney injury are unknown. The study objective was to determine whether contrast administration within the first 24 hours was associated with acute kidney injury in survivors of sudden cardiac arrest.
  
  
  METHODS
  This cohort study, derived from a prospective clinical trial, included patients with sudden cardiac arrest who survived for 48 hours, had no history of end-stage renal disease, and had at least 2 serum creatinine measurements during hospitalization. The contrast group included patients with exposure to iodinated contrast within 24 hours of sudden cardiac arrest. Incident acute kidney injury and first-time dialysis were compared between contrast and no contrast groups and then controlled for known acute kidney injury risk factors.
  
  
  RESULTS
  Of the 199 survivors of sudden cardiac arrest, 94 received iodinated contrast. Mean baseline serum creatinine level was 1.3 mg/dL (95% confidence interval [CI] 1.4 to 1.5 mg/dL) for the contrast group and 1.6 mg/dL (95% CI 1.4 to 1.7 mg/dL) for the no contrast group. Incident acute kidney injury was lower in the contrast group (12.8%) than the no contrast group (17.1%; difference 4.4%; 95% CI -9.2% to 17.5%). Contrast administration was not associated with significant increases in incident acute kidney injury within quartiles of baseline serum creatinine level or after controlling for age, sex, race, congestive heart failure, diabetes, and admission serum creatinine level by regression analysis. Older age was independently associated with acute kidney injury.
  
  
  CONCLUSIONS
  Despite elevated baseline serum creatinine level in most survivors of sudden cardiac arrest, iodinated contrast administration was not associated with incident acute kidney injury even when other acute kidney injury risk factors were controlled for. Thus, although acute kidney injury is not uncommon among survivors of sudden cardiac arrest, early (<24 hours) contrast administration from imaging procedures did not confer an increased risk for acute kidney injury.
authors.affiliation: University of Washington School of Medicine, Seattle, WA.
authors.forename: Bradley J
authors.initials: BJ
authors.lastname: Petek
authors.affiliation: Division of Cardiology, University of Washington School of Medicine, Seattle, WA.
authors.forename: Paco E
authors.initials: PE
authors.lastname: Bravo
authors.affiliation: Division of Cardiology, University of Washington School of Medicine, Seattle, WA.
authors.forename: Francis
authors.initials: F
authors.lastname: Kim
authors.affiliation: Division of Nephrology, University of Washington School of Medicine, Seattle, WA.
authors.forename: Ian H
authors.initials: IH
authors.lastname: de Boer
authors.affiliation: Division of Cardiology, University of Washington School of Medicine, Seattle, WA.
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Kudenchuk
authors.affiliation: Department of Radiology, University of Washington School of Medicine, Seattle, WA.
authors.forename: William P
authors.initials: WP
authors.lastname: Shuman
authors.affiliation: Department of Radiology, University of Washington School of Medicine, Seattle, WA.
authors.forename: Martin L
authors.initials: ML
authors.lastname: Gunn
authors.affiliation: Division of Pulmonary Critical Care Medicine, University of Washington School of Medicine, Seattle, WA.
authors.forename: David J
authors.initials: DJ
authors.lastname: Carlbom
authors.affiliation: Division of Cardiology, University of Washington School of Medicine, Seattle, WA.
authors.forename: Edward A
authors.initials: EA
authors.lastname: Gill
authors.affiliation: Division of Cardiology, University of Washington School of Medicine, Seattle, WA.
authors.forename: Charles
authors.initials: C
authors.lastname: Maynard
authors.affiliation: Division of Cardiology, University of Washington School of Medicine, Seattle, WA. Electronic address: kbranch@cardiology.washington.edu.
authors.forename: Kelley R
authors.initials: KR
authors.lastname: Branch
mesh_terms: D058186:Acute Kidney Injury / Q000139:chemically induced* / Q000628:therapy; D000368:Aged; D015415:Biomarkers / Q000097:blood; D003287:Contrast Media / Q000009:adverse effects*; D017023:Coronary Angiography; D003404:Creatinine / Q000097:blood; D005260:Female; D006323:Heart Arrest / Q000000981:diagnostic imaging*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D006435:Renal Dialysis; D012307:Risk Factors; D014057:Tomography, X-Ray Computed
chemical_list: D015415:Biomarkers; D003287:Contrast Media; D003404:Creatinine