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Incidence and outcome of contrast-associated acute kidney injury assessed with Risk, Injury, Failure, Loss, and End-stage kidney disease (RIFLE) criteria in critically ill patients of medical and surgical intensive care units: a retrospective study

Authors
 Myoung Hwa Kim  ;  Shin Ok Koh  ;  Eun Jung Kim  ;  Jin Sun Cho  ;  Sung-Won Na 
Citation
 BMC Anesthesiology, Vol.15 : 23-23, 2015 
Journal Title
 BMC Anesthesiology 
ISSN
 1471-2253 
Issue Date
2015
Abstract
BACKGROUND: Contrast medium used for radiologic tests can decrease renal function. However there have been few studies on contrast-associated acute kidney injury in intensive care unit (ICU) patients. The objective of this study was to evaluate the incidence, characteristics, and outcome of contrast-associated acute kidney injury (CA-AKI) patients using the Risk, Injury, Failure, Loss, and End-stage kidney disease (RIFLE) criteria in critically ill patients in the ICU. METHODS: We conducted a retrospective study of adult patients who underwent contrast-enhanced radiologic tests from January 2011 to December 2012 in a 30-bed medical ICU and a 24-bed surgical ICU. RESULTS: The study included 335 patients, and the incidence of CA-AKI was 15.5%. The serum creatinine and estimated glomerular filtration rate values in the CA-AKI patients did not recover even at discharge from the hospital compared with the values prior to the contrast use. Among 52 CA-AKI patients, 55.8% (n = 29) had pre-existing kidney injury and 44.2% (n = 23) did not. The CA-AKI patients were divided into risk (31%), injury (31%), and failure (38%) by the RIFLE classification. The percentage of patients in whom AKI progressed to a more severe form (failure, loss, end-stage kidney disease) increased from 38% to 45% during the hospital stay, and the recovery rate of AKI was 17% at the time of hospital discharge. Because the Acute Physiology and Chronic Health Evaluation (APACHE) II score was the only significant variable inducing CA-AKI, higher APACHE II scores were associated with a higher risk of CA-AKI. The ICU and hospital mortality of patients with CA-AKI was significantly higher than in patients without CA-AKI. CONCLUSIONS: CA-AKI is associated with increases in hospital mortality, and can be predicted by the APACHE score.
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DOI
10.1186/s12871-015-0008-x
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Anesthesiology and Pain Medicine (마취통증의학교실) > 1. Journal Papers
Yonsei Authors
고신옥(Koh, Shin Ok)
김명화(Kim, Myoung Hwa) ORCID logo https://orcid.org/0000-0003-4723-9425
김은정(Kim, Eun Jung) ORCID logo https://orcid.org/0000-0002-5693-1336
나성원(Na, Sungwon) ORCID logo https://orcid.org/0000-0002-1170-8042
조진선(Cho, Jin Sun) ORCID logo https://orcid.org/0000-0002-5408-4188
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URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/140055
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