Evaluation of the development of contrast-associated acute kidney damage and risk factors in patients who received contrast computed tomography in the emergency department

Introduction: In this study, the frequency of contrast-associated acute kidney damage for the patients had contrast-enhanced computerized tomography and the risk factors are analyzed. Because of their aid at diagnosis and treatment, the use of contrast agents had increased. On the other hand, it leads several side effects not excepting contrast-associated acute kidney damage. Contrast-associated acute kidney damage is associated with prolonged hospitalization and increase of chronic kidney disease risk. Objective: By this study, it is aimed to research the frequency of contrast-associated acute kidney damage, the risk factors of contrast-associated acute kidney damage and the efficiency of these risk factors at predicting contrast-associated acute kidney damage. The sample of this study consists of the patients had contrast-enhanced computerized tomography in the emergency service of Bolu Abant İzzet Baysal University Training and Research Hospital. Materials and methods: The patients aged 18 and older without diagnosed chronic renal failure, who applied to the emergency service of our hospital between the dates 25.10.2023-25.10.2024 and had contrast-enhanced computerized tomography by injecting intravenous contrast agent, are prospectively included in the study. These patients are scanned in terms of age, gender, comorbidities, AF, preoperative blood pressure and HGB value, discharge-hospitalization in service-hospitalization in intensive care unit and the amount of contrast agent used for tomography. Contrast-associated acute kidney damage is described as a 0,5 mg/dL (44 μmol/L) or 25% rise in serum creatinine according to the first value within 2-5 days after the contrast agent application. Results: 125 patients are included in this study. It is detected that contrast-associated acute kidney damage occurred at 17 patients (13,6%). By comparing the patients who have contrast-associated acute kidney damage and the patients who do not have it in terms of preoperative blood pressure values, it is observed that the existence of hypotension before the process is related to increased risk. At the patients with AF, contrast-associated acute kidney damage ratio is observed as 30% and it is detected that AF is related to increased risk of contrast-associated acute kidney damage. A significant relation is found between the outcome situation of the patients and the contrast-associated acute kidney damage development. It is detected that the patients hospitalized in intensive care units have more risk for contrast- associated acute kidney damage. Conclusion: Contrast-associated acute kidney damage risk is high for the patients who have hypotension before the process, who have AF in the ECG and who hospitalized in intensive care unit. KEYWORDS: Emergency Service, Contrast-Enhanced Computerized Tomography, Contrast-Associated Acute Kidney Damage.