Contrast-Associated AKI in Hospitalized Adults With Sickle Cell Disease

Area of Science:

• Nephrology
• Hematology
• Radiology

Background:

• Sickle cell disease (SCD) patients are susceptible to chronic kidney disease (CKD) and acute kidney injury (AKI).
• The association between contrast media (CM) and AKI in SCD patients remains unclear.
• This study investigates the temporal relationship between CM exposure and AKI in hospitalized SCD adults.

Purpose of the Study:

• To evaluate the risk of acute kidney injury (AKI) following contrast media (CM) exposure in patients with sickle cell disease (SCD).
• To determine the temporal association between CM administration and AKI incidence in a hospitalized SCD cohort.
• To differentiate the impact of CM from underlying clinical factors on AKI risk in SCD.

Main Methods:

• Retrospective self-controlled case series (SCCS) design.
• Inclusion of adult SCD patients hospitalized between 2013-2022.
• Analysis of AKI incidence during pre-exposure and post-exposure periods relative to CM exposure, controlling for confounders.

Main Results:

• AKI incidence significantly increased in the 7 days before and up to 7 days after CM exposure (RI: 2.53 and 2.52, respectively).
• Higher relative incidences (RI) were observed for severe AKI (Stage 2 or 3).
• The observed AKI patterns suggest underlying clinical conditions, not CM, are the primary drivers.

Conclusions:

• In hospitalized SCD adults, AKI risk is elevated both before and after CM exposure.
• The findings suggest that underlying clinical factors and associated medical interventions, rather than CM, are likely responsible for the increased AKI risk.
• Further research may be needed to elucidate the specific mechanisms contributing to AKI in this population.