Abstract 14585: Contrast Induced Acute Kidney Injury and Clinical Outcome after Intra-Arterial and Intravenous Contrast Administration: Risk Assessment Adjusted for Patient Characteristics by Design

Abstract

Purpose To analyze the relative risk and clinical course of contrast induced acute kidney injury (CI-AKI) after intra-arterial (IA) versus intravenous (IV) contrast administration in patients who underwent both.

Materials and Methods We included 170 patients who received both IA and IV contrast injections within one year period between the year 2001-2010. Primary outcomes were the incidences of CI-AKI (i.e. increase in serum creatinine >25%/>0.5mg/dl) and its relative risk after IA versus IV contrast administration. Secondary outcomes were duration of hospital stay, the need for dialysis, recovery of renal function and mortality.

Results Mean age of the population was 70 years (SD14), 64% were male, and 55% had an estimated glomerular filtration rate < 60 ml/min. The relative risk of CI-AKI after IA compared with IV contrast administration was 1.2(95% CI0.7-2.1). None of the patients had a need for dialysis. Median duration of hospital stay in CI-AKI patients was 15 days (2.5-97.5 percentile 1-92) after IA and 15 days (2.5-97.5 percentile 0-38) after IV contrast procedures. Cumulative renal function recovery rates after CI-AKI were 76.5%(IA group, 95%CI56.3-96.7) and 84.1%(IV group, 95%CI57.7-100), respectively. Mortality risk in CI-AKI patients was slightly higher than in patients who did not develop CI-AKI, i.e. hazard ratios of 1.6(95%CI0.7-3.7) for IA and 1.7(95%CI0.7-4.4) for IV contrast administration, adjusted for confounders.

Conclusion The risk of CI-AKI was similar after IA and IV contrast procedures. Moreover, the risk of CI-AKI associated hospital stay, renal recovery rate and mortality risk appear to be equivalent between the two routes of contrast administration.