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Incidence of contrast-induced acute kidney injury in a pediatric setting: a cohort study
Aymeric Cantais1, Zeineb Hammouda2, Olivier Mory1
1Pediatrics Emergency department, Saint-Etienne University Hospital, Saint-Etienne, France.
Insights
Contrast-induced acute kidney injury (CI-AKI) affects 10.3% of pediatric patients after contrast media exposure. This condition is linked to worse outcomes, highlighting the need for vigilance in pediatric care.
Area of Science:
- Pediatric Nephrology
- Radiology
- Critical Care Medicine
Background:
- Contrast-induced acute kidney injury (CI-AKI) is a known complication in adults undergoing procedures with iodinated contrast media.
- Data on CI-AKI incidence, risk factors, and outcomes in pediatric patients are limited.
Purpose of the Study:
- To determine the incidence of CI-AKI in pediatric patients.
- To investigate the risk factors associated with CI-AKI in children.
- To evaluate the prognostic impact of CI-AKI on pediatric patient outcomes.
Main Methods:
- Retrospective study of pediatric patients undergoing CT scans with iodinated contrast media from 2005-2014.
- CI-AKI diagnosis based on Kidney Disease/Improving Global Outcomes (KDIGO) criteria.
- Analysis of 233 patients with available renal function follow-up.
Main Results:
- CI-AKI incidence was 10.3% in the studied pediatric population.
- CI-AKI was significantly associated with a 30-day unfavorable outcome (OR 3.6).
- No independent risk factors for CI-AKI were identified in this cohort.
Conclusions:
- CI-AKI occurs in 10.3% of pediatric patients receiving intravenous contrast media.
- Similar to adults, CI-AKI in children is associated with adverse outcomes.
- Healthcare providers should maintain a high index of suspicion for CI-AKI in pediatric patients.
Background:
Contrast-induced acute kidney injury (CI-AKI) is a common pathology among adult patients, with an incidence ranging from 3-25 % depending on risk factors. Little information is available regarding CI-AKI incidence, risk factors, and prognostic impact in the pediatric population.
Methods:
We performed a retrospective study of pediatric patients who underwent computed tomography (CT) scan with iodinated contrast media injection between 2005 and 2014 in five pediatric units of a university hospital. CI-AKI was defined according to Kidney Disease/Improving Global Outcomes (KDIGO) criteria.
Results:
Of 346 identified patients, 233 had renal function follow-up and were included in our analyses. CI-AKI incidence was 10.3 % [95 % confidence interval (CI) 6.4-14.2 %]. CI-AKI was associated with 30-day unfavorable outcome before (45.8 % vs. 19.7 %, P = 0.007) and after [odds ratio (OR) 3.6; 95 % CI 1.4-9.5] adjustment for confounders. No independent risk factors of CI-AKI were identified.
Conclusions:
CI-AKI incidence was as high as 10.3 % following intravenous contrast media administration in the pediatric setting. As reported among adults, CI-AKI was associated with unfavorable outcome after adjustment for confounders. Although additional studies are needed in the pediatric setting, our data suggest that physicians should maintain a high degree of suspicion toward this complication among pediatric patients.
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