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Contrast Volume to Estimated GFR Ratio for Prediction of Contrast-Induced Acute Kidney Injury

Description

Gellis et al identified risk factors for contrast-induced acute kidney injury in adults with congenital heart disease. These can help to identify a patient who may benefit from more aggressive management or who may benefit from a non-contrast technique. The authors are from Boston Children's Hospital.


Patient selection: adult with congenital heart disease undergoing cardiac catheterization

 

Outcome: contrast-induced acute kidney injury (increase in serum creatinine within 48 hours >= 0.3 mg/dL, OR serum creatinine within 7 days >= 1.5 times the baseline serum creatinine)

 

Parameters:

(1) volume of contrast in mL

(2) estimated glomerular filtration rate (eGFR)

 

ratio =

= (volume of contrast) / eGFR

 

Interpretation:

• A ratio >= 2.6 was associated with acute kidney injury (OR 6.4). In addition, it was associated with worse survival (about 50% at 3 year).

 

Additional risk factors:

(1) older age

(2) male sex

(3) admission prior to catheterization


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