Acute Kidney Injury After CT
Aycock, Ryan D., et al. “Acute Kidney Injury After Computed Tomography: A Meta-analysis.” Annals of Emergency Medicine (2017).
Computed tomography (CT) is an important imaging modality used in the diagnosis of a variety of disorders. Imaging quality and diagnostic accuracy are improved with use of IV contrast material. There has long been a concern for potential renal injury with use of IV contrast. The goal of this study was to compare the risk of acute kidney injury, need for renal replacement, and total mortality after contrast-enhanced CT versus noncontrast CT via a meta-analysis.
28 studies involving 107,335 participants were included in the final analysis. All of the included studies were observational. A meta-analysis was then performed to compare non-contrast CT and contrast-enhanced CT.
Meta-analysis demonstrated that, compared with noncontrast CT, contrast-enhanced CT was not significantly associated with either acute kidney injury (odds ratio [OR] 0.94; 95% confidence interval [CI] 0.83 to 1.07), need for renal replacement therapy (OR 0.83; 95% CI 0.59 to 1.16), or all-cause mortality (OR 1.0; 95% CI 0.73 to 1.36).
There were no significant differences in the principal study outcomes between patients receiving contrast-enhanced CT versus those receiving noncontrast CT. It is important to remember that other patient and disease related factors likely contribute to the development of acute kidney injury in patients who require advanced imaging.