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A novel risk factor of contrast associated acute kidney injury in patients after enhanced computed tomography: a

You-Qi Li1,2, Yongjun Shi2, Wen-Feng Deng3

  • 1Nephrology, Zhujiang Hospital, Southern Medical University, GuangZhou, GuangDong, China.

Peerj
|October 26, 2022
PubMed

Insights

Red blood cell distribution width (RDW) and estimated glomerular filtration rate (eGFR) are key risk factors for contrast-associated acute kidney injury (CA-AKI) after enhanced CT scans. RDW shows significant predictive value for early CA-AKI detection.

Area of Science:

  • Nephrology
  • Radiology
  • Clinical Biochemistry

Background:

  • Contrast-associated acute kidney injury (CA-AKI) remains a significant cause of acute renal failure.
  • Current risk stratification relies on estimated glomerular filtration rate (eGFR), necessitating exploration of novel risk factors.
  • Enhanced computed tomography (CT) procedures increase the risk of CA-AKI.

Purpose of the Study:

  • To identify novel risk factors for CA-AKI following enhanced CT.
  • To evaluate the predictive value of red blood cell distribution width (RDW) for CA-AKI.
  • To compare the predictive performance of RDW against eGFR for CA-AKI.

Main Methods:

  • Retrospective cohort study of 632 patients undergoing enhanced CT.
  • Propensity score matching (PSM) used to balance baseline characteristics between CA-AKI and no-CA-AKI groups.
  • Logistic regression and ROC curve analysis employed to identify risk factors and assess predictive value of RDW.

Main Results:

  • 25 patients (3.96%) developed CA-AKI.
  • CA-AKI patients had higher baseline RDW, lower albumin, and lower eGFR compared to controls.
  • RDW demonstrated a good predictive ability for CA-AKI (AUC 0.803), outperforming eGFR (AUC 0.765) in some analyses.

Conclusions:

  • Increased baseline RDW and decreased eGFR are significant risk factors for CA-AKI post-enhanced CT.
  • RDW serves as a valuable early warning marker for predicting CA-AKI.
  • RDW offers a promising tool for risk stratification in patients undergoing contrast-enhanced CT.
Abstract

Keywords:
Computed tomographyContrast associated acute kidney injuryRed blood cell distribution width

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