Postcontrast Acute Kidney Injury After Computed Tomography Pulmonary Angiography for Acute Pulmonary Embolism

Abstract

Background: Despite the widespread use of computed tomography pulmonary angiography with contrast media for the diagnosis of acute pulmonary embolism, high-quality evidence on risk factors for postcontrast acute kidney injury related to its use is lacking.

Objective: The present study aimed to investigate whether the level of estimated glomerular filtration rate observed in the emergency department (ED) is significantly associated with the occurrence of postcontrast acute kidney injury in patients undergoing computed tomography pulmonary angiography.

Methods: We performed a retrospective observational study using data automatically collected by a clinical data retrieval system from 1300 patients who underwent computed tomography pulmonary angiography for suspected acute pulmonary embolism in the ED. A total of 632 patients were selected for the study after exclusion. Univariate analyses were performed to identify significant risk factors for postcontrast acute kidney injury (the primary outcome). Multivariate logistic regression analysis was used to confirm the effect of estimated glomerular filtration rate in the ED on the occurrence of postcontrast acute kidney injury after adjustment for confounding variables.

Results: The total incidence rate of postcontrast acute kidney injury was 6.49% (41/632 patients). No statistically significant association between estimated glomerular filtration rate and the risk of postcontrast acute kidney injury was observed.

Conclusion: Our study findings could serve as useful reference for physicians who are concerned about performing computed tomography pulmonary angiography for fear of renal function deterioration.