A Retrospective Comparison of Creatinine Changes Among Patients Receiving, Not Receiving, and Not Yet Receiving...

Area of Science:

• Nephrology
• Radiology
• Clinical Chemistry

Background:

• Serum creatinine is a key indicator of kidney function.
• Contrast imaging studies are common in inpatient settings.
• Understanding creatinine variability is crucial for diagnosing acute kidney injury (AKI).

Purpose of the Study:

• To compare serum creatinine variability in inpatients receiving contrast imaging versus those not receiving it.
• To assess changes in serum creatinine within 48 hours of contrast administration.
• To investigate potential factors influencing creatinine changes, such as hydration therapy.

Main Methods:

• Retrospective study of electronic medical record data from an academic medical center.
• Analysis of serum creatinine changes in three cohorts: no contrast, before contrast, and after contrast.
• Comparison of absolute and relative creatinine changes over periods no longer than 48 hours.

Main Results:

• Similar creatinine increases (>0.3 mg/dL) were observed in patients not receiving contrast (18.3%) and those before contrast (14.2%).
• Fewer patients showed significant creatinine increases after contrast (6.4%).
• Pre-contrast creatinine increases correlated with post-contrast increases (Pearson's 0.48, P < .001).

Conclusions:

• Physiological variability may account for creatinine changes in non-contrast groups.
• Hydration therapy might explain reduced creatinine increases post-contrast.
• Results support equipoise for randomized trials to determine if contrast causes AKI.