Contrast-Associated Acute Kidney Injury in Oncology Patients During Active Chemotherapy: A Saudi Arabian...

BACKGROUND Contrast-associated acute kidney injury (CA-AKI) is a recognized complication in oncology patients undergoing contrast-enhanced computed tomography (CECT) during chemotherapy. Limited data exist on CA-AKI incidence in patients with preserved baseline renal function, particularly in Middle Eastern populations. MATERIAL AND METHODS We conducted a retrospective analysis of 146 adult oncology patients with baseline estimated glomerular filtration rate (eGFR) greater than 50 mL/min/1.73 m² who underwent CECT within 45 days of chemotherapy at a tertiary cancer center in Saudi Arabia (January 2017-December 2018). CA-AKI was defined as an absolute serum creatinine increase of 0.3 mg/dL or more, or as a relative increase of more than 50% within 48 to 72 hours of contrast administration. Given the small number of events (n=2), descriptive statistics and exploratory univariate analyses were performed. RESULTS CA-AKI occurred in 2 of 146 patients (1.4%; 95% CI: 0.2%-5.0%). Mean age was 51.5±16.2 years; 58% were women. Cancer types included solid tumors (81.5%) and hematological malignancies (17.8%). The chemotherapy-to-CECT interval was shorter in patients with CA-AKI (mean: 2 days) than in patients without CA-AKI (mean: 23.3±12.8 days; P=0.02). This association is exploratory and hypothesis-generating given the extremely limited number of events. CONCLUSIONS CA-AKI incidence was relatively low (1.4%) in oncology patients with preserved baseline renal function undergoing CECT during active chemotherapy. The observed association between shorter chemotherapy-to-imaging intervals and CA-AKI requires prospective validation and should not be interpreted as a definitive causal relationship. These findings provide preliminary regional data from Saudi Arabia and underscore the need for larger, well-designed prospective studies to better characterize CA-AKI risk in this population.