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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

 Myoung Hwa Kim  ;  Shin Ok Koh  ;  Eun Jung Kim  ;  Jin Sun Cho  ;  Sung-Won Na 
 BMC ANESTHESIOLOGY, Vol.15 : 23, 2015 
Journal Title
Issue Date
Acute Kidney Injury/blood ; Acute Kidney Injury/chemically induced* ; Acute Kidney Injury/epidemiology* ; Acute Kidney Injury/physiopathology ; Aged ; Contrast Media/adverse effects* ; Creatinine/blood ; Critical Illness/epidemiology* ; Critical Illness/mortality ; Disease Progression ; Female ; Glomerular Filtration Rate ; Hospital Mortality ; Humans ; Incidence ; Intensive Care Units* ; Kidney Failure, Chronic/blood ; Kidney Failure, Chronic/diagnosis ; Kidney Failure, Chronic/epidemiology* ; Kidney Failure, Chronic/physiopathology ; Male ; Middle Aged ; Republic of Korea/epidemiology ; Retrospective Studies ; Risk Factors ; Severity of Illness Index
Contrast-associated acute kidney injury ; Intensive care unit ; RIFLE classification
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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1. College of Medicine (의과대학) > Dept. of Anesthesiology and Pain Medicine (마취통증의학교실) > 1. Journal Papers
Yonsei Authors
Koh, Shin Ok(고신옥)
Kim, Myoung Hwa(김명화) ORCID logo https://orcid.org/0000-0003-4723-9425
Kim, Eun Jung(김은정) ORCID logo https://orcid.org/0000-0002-5693-1336
Na, Sungwon(나성원) ORCID logo https://orcid.org/0000-0002-1170-8042
Cho, Jin Sun(조진선) ORCID logo https://orcid.org/0000-0002-5408-4188
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