Evaluation of the risk of development of contrast nephropathy and predisposing factors in patients admitted from emergency department to intensive care unit

Objective: In this study, we aimed to determine the incidence and risk factors of contrast nephropathy in patients hospitalised from the emergency department to the intensive care unit. All patients who were hospitalised from the emergency department to the intensive care unit and who underwent imaging studies with or without contrast at admission or during hospitalisation were included in the study. Materials and Methods: This is a retrospective, observational, single-centre cohort study conducted in the Emergency Department and Intensive Care Unit of Bolu Abant Izzet Baysal University Education and Research Hospital between January 2021 and June 2024. All patients who were admitted from the emergency department to the intensive care unit and underwent imaging examinations with or without contrast on admission or during hospitalisation were included in the study. These patients were screened for contrast media uptake, acute kidney injury and various parameters. Acute kidney injury was defined as an increase in serum creatinine level of 0,3 mg/dL or more within 48-72 hours after admission. Statistical analysis was performed using Jamovi and significance level was accepted as p<0,05. Results: A total of 626 adult patients hospitalised from the emergency department to the intensive care unit were included in this study. Of the participants, 419 (66.9%) were non-contrast-exposed and 207 (33.1%) were contrast-administered patients. The rate of AKI development was 23.2% in the contrast-exposed group and 21,2% in the non-contrast-exposed group. No significant correlation was observed between contrast media and AKI. A significant relationship was observed between vasopressor use, ventilator use, sepsis, mortality and AKI. Conclusion: It has been shown that contrast media use is not directly associated with the development of AKI, but accompanying clinical conditions (need for vasopressors, ventilator support, sepsis, etc.) in intensive care conditions significantly increase the risk of AKI.