title: Incidences of acute kidney injury, dialysis, and graft loss following intravenous administration of low-osmolality iodinated contrast in patients with kidney transplants.
abstract: To determine the incidence of acute kidney injury (AKI), need for emergent dialysis, and renal graft loss in patients with kidney transplants, who underwent CT examinations with low-osmolality iodine-based contrast material (IBCM).
  
  
  
  Our institutional review board approved this retrospective Health Insurance Portability and Accountability Act compliant study. From January 2005 to April 2015, a total of 224 CT examinations were performed using low-osmolality IBCM in patients with kidney transplants. Six patients who had septic or cardiogenic shock and 30 patients with documented, failed transplants were excluded from our analysis, yielding a total of 188 examinations. Of these, pre- and post-CT serum creatinine (SCr) values were available for 104 examinations, to allow evaluation of AKI. The mean baseline SCr and estimated glomerular filtration rate (eGFR) in this subgroup were 1.37 mg/dL (median 1.18, range 0.5-6.05) and 65.8 mL/min/1.73 m2, respectively (median 65, range 9-114). AKI was defined as a rise in SCr of either (a) ≥0.3 mg/dL or (b) ≥0.5 mg/dL in the 24- to 72-h period following IBCM administration. For all patients undergoing the 188 examinations, need for dialysis and graft loss 30 days after contrast administration were evaluated.
  
  
  
  In patients with pre- and post-CT SCr values, the incidence of AKI was 7% (7/104) based on a rise of ≥0.3 mg/dL and 3% (3/104) based on a rise of ≥0.5 mg/dL. All three patients with the more strict definition (≥0.5 mg/dL) had a pre-CT eGFR <60 mL/min/1.73 m2. No patient required dialysis or had renal graft loss 30 days after contrast administration.
  
  
  
  The incidence of AKI after administration of low-osmolality IBCM administration in renal transplant recipients is low, with no instances of emergent dialysis or graft loss at 30 days post contrast.
authors.affiliation: Department of Radiology, University of California Davis Medical Center, 4860 Y Street, Suite 3100, Sacramento, CA, 95817, USA. fananapazir@ucdavis.edu.
authors.forename: Ghaneh
authors.initials: G
authors.lastname: Fananapazir
authors.affiliation: Department of Surgery, University of California Davis Medical Center, 2221 Stockton Boulevard, Suite B, Sacramento, CA, 95817, USA.
authors.forename: Christoph
authors.initials: C
authors.lastname: Troppmann
authors.affiliation: Department of Radiology, University of California Davis Medical Center, 4860 Y Street, Suite 3100, Sacramento, CA, 95817, USA.
authors.forename: Michael T
authors.initials: MT
authors.lastname: Corwin
authors.affiliation: Department of Radiology, University of California Davis Medical Center, 4860 Y Street, Suite 3100, Sacramento, CA, 95817, USA.
authors.forename: Arian M
authors.initials: AM
authors.lastname: Nikpour
authors.affiliation: Department of Radiology, University of California Davis Medical Center, 4860 Y Street, Suite 3100, Sacramento, CA, 95817, USA.
authors.forename: Sima
authors.initials: S
authors.lastname: Naderi
authors.affiliation: Department of Radiology, University of California Davis Medical Center, 4860 Y Street, Suite 3100, Sacramento, CA, 95817, USA.
authors.forename: Ramit
authors.initials: R
authors.lastname: Lamba
mesh_terms: D058186:Acute Kidney Injury / Q000139:chemically induced* / Q000453:epidemiology / Q000628:therapy; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003287:Contrast Media / Q000008:administration & dosage / Q000009:adverse effects*; D005260:Female; D005919:Glomerular Filtration Rate; D006084:Graft Rejection; D006801:Humans; D015994:Incidence; D007472:Iohexol / Q000008:administration & dosage / Q000009:adverse effects*; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D009994:Osmolar Concentration; D006435:Renal Dialysis; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D014283:Triiodobenzoic Acids / Q000008:administration & dosage / Q000009:adverse effects*
chemical_list: D003287:Contrast Media; D014283:Triiodobenzoic Acids; D007472:Iohexol; C044834:iodixanol
keywords: CT; Contrast; Contrast-induced nephropathy; Kidney; Transplant