Risk factors of contrast induced acute kidney injury -a single centre study in a tertiary hospital of bangladesh

Background: Contrast induced Acute Kidney Injury (CI-AKI) is a potentially reversible cause of acute kidney Injury (AKI) following intravascular contrast administration. Common diagnostic procedures like computed tomography (CT), coronary angiogram (CAG) and intravenous urography (IVU) utilize intravascular iodinated contrast media. This cross sectional observational study was conducted in a tertiary hospital of Bangladesh to assess the proportion of CI-AKI with their risk factors over a period of six months. Material and Methods: Total 50 patients were included in the study. Twenty four had hypertension (HTN) and 14 had Diabetes mellitus (DM). Serum creatinine (Scr) of fourteen patients was ≥ 1.2 mg/dl. We measured serum creatinine at baseline (before procedure) and 48 hours after the procedure. CI-AKI was defined as rise in serum creatinine ≥ 0.5 mg/dl or 25% rise from baseline. Data was analyzed by computer based software SPSS-19 and p value <0.05 was considered statistically significant. Results: Among 14 diabetic patients seven (50.0%) developed CI-AKI, among 24 hypertensive patients six (25.0%) developed CI-AKI, among 14 patients with baseline serum creatinine level ≥ 1.2 mg/dl ten (71.4%) developed CI-AKI. Statistical analysis showed base line serum creatinine ≥ 1.2 mg/dl (p<0.000) and DM (p<0.05) are the important predictor for the development of CI-AKI. Though CI-AKI was more in the hypertensive, male and age >50 years, but there was no statistical significance (p>0.05). Diabetic patients and patients with Scr. ≥ 1.2 mg/dl had 2.5 times and 6.4 times higher risk of developing CI-AKI respectively. Conclusions: Though it was a small hospital based cross sectional descriptive study, yet Diabetes and even mild degree of renal insufficiency were found to be risk factors predicting CI-AKI following coronary angiogram, contrast CT and IVU.