title: Incidence of contrast-induced acute kidney injury in a pediatric setting: a cohort study.
abstract: 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.
  
  
  
  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.
  
  
  
  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.
  
  
  
  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.
authors.affiliation: Pediatrics Emergency department, Saint-Etienne University Hospital, Saint-Etienne, France.
authors.forename: Aymeric
authors.initials: A
authors.lastname: Cantais
authors.affiliation: Intensive Care Unit, Fattouma Bourguiba Monatir University hospital, Monatir, Tunisia.
authors.forename: Zeineb
authors.initials: Z
authors.lastname: Hammouda
authors.affiliation: Pediatrics Emergency department, Saint-Etienne University Hospital, Saint-Etienne, France.
authors.forename: Olivier
authors.initials: O
authors.lastname: Mory
authors.affiliation: Pediatrics Intensive Care Unit, Saint-Etienne University Hospital, Saint-Etienne, France.
authors.forename: Hugues
authors.initials: H
authors.lastname: Patural
authors.affiliation: Pediatrics Oncology, Saint-Etienne University Hospital, Saint-Etienne, France.
authors.forename: Jean-Louis
authors.initials: JL
authors.lastname: Stephan
authors.affiliation: Pediatrics Radiology Department, Saint-Etienne University Hospital, Saint-Etienne, France.
authors.forename: Lyudmyla
authors.initials: L
authors.lastname: Gulyaeva
authors.affiliation: Medical-Surgical Intensive Care Unit, Saint-Etienne University Hospital, Avenue Albert Raimond, 42270, Saint-Priest-en-Jarez, France. michael.darmon@chu-st-etienne.fr.
authors.forename: Michael
authors.initials: M
authors.lastname: Darmon
mesh_terms: D058186:Acute Kidney Injury / Q000139:chemically induced* / Q000453:epidemiology*; D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D003287:Contrast Media / Q000009:adverse effects*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods
chemical_list: D003287:Contrast Media
keywords: Acute kidney injury; Contrast-associated nephropathy; Incidence; Pediatrics; Prognosis; Risk factors