Factors associated with contrast-associated acute kidney injury in an emergency department: A cohort study in Lebanon.

Publisher: Public Library of Science Country of Publication: United States NLM ID: 101285081 Publication Model: eCollection Cited Medium: Internet ISSN: 1932-6203 (Electronic) Linking ISSN: 19326203 NLM ISO Abbreviation: PLoS One Subsets: MEDLINE

Original Publication: San Francisco, CA : Public Library of Science

Acute Kidney Injury*/chemically induced ; Acute Kidney Injury*/epidemiology ; Emergency Service, Hospital*/statistics & numerical data ; Contrast Media*/adverse effects; Humans ; Male ; Female ; Lebanon/epidemiology ; Middle Aged ; Retrospective Studies ; Aged ; Risk Factors ; Adult ; Tomography, X-Ray Computed/adverse effects ; Cohort Studies ; Creatinine/blood ; Aged, 80 and over

Competing Interests: The authors have declared that no competing interests exist.
Background: Contrast-associated acute kidney injury (CA-AKI) is a common problem in hospitals, particularly in low-middle-income countries (LMIC), due to limited resources and a high prevalence of comorbidities. Kidney function evaluation using serum creatinine levels before contrast administration leads to increased length of stay and delayed patient care. This study aimed to identify factors associated with CA-AKI in emergency department (ED) patients in an LMIC. Identifying these factors is essential for enhancing patient care and guiding clinical practice by allowing for the early detection and management of patients at risk.
Methods: This study is a retrospective cohort study conducted at the largest tertiary care center's ED in Lebanon between November 2018 and December 2019. The study included ED patients who underwent computed-tomography (CT) with contrast. Bivariate and logistic regression analyses were performed to compare the characteristics of patients who developed AKI with those who did not by using SPSS package. The Institutional Review Board (IRB) at the American University of Beirut (AUB) approved this study under protocol ID BIO-2020-0276, which was performed per the Declaration of Helsinki. The IRB waived the need to consent patients since many of them were not followed up at the time of the study.
Results: The study included 1832 patients, of whom 10.4% (n = 190) developed CA-AKI. Patients aged over 65 had a 1.6-fold higher risk of CA-AKI (aOR = 1.55, 95%CI:1.09-2.2). High blood pressure (≥140 mmHg), high respiratory rate ( ≥ 22), and chronic kidney disease were significantly associated with CA-AKI. The use of loop diuretics (aOR = 2.21, 95%CI:1.49-3.28), beta-lactams (aOR = 4.11, 95%CI:2.63-6.42), and allopurinol (aOR = 2.74, 95%CI:1.43-5.25) were significantly associated with CA-AKI.
Conclusions: Identifying factors associated with CA-AKI in an emergency setting, such as age, comorbidities, and home medications, can help identify patients at low risk of developing CA-AKI.
(Copyright: © 2025 Al Hariri et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Kidney Int. 2005 Nov;68(5):2250-5. (PMID: 16221226)
Circulation. 2023 Mar 14;147(11):847-849. (PMID: 36913495)
J Transl Med. 2020 Oct 20;18(1):400. (PMID: 33081797)
BMC Nephrol. 2021 Aug 25;22(1):289. (PMID: 34433442)
Kidney Int. 2012 May;81(9):819-25. (PMID: 21975865)
Eur Heart J. 2012 Aug;33(16):2007-15. (PMID: 22267241)
Eur J Radiol. 2020 Aug;129:109074. (PMID: 32473539)
Eur Radiol. 2011 Dec;21(12):2527-41. (PMID: 21866433)
Miner Electrolyte Metab. 1994;20(4):221-31. (PMID: 7845324)
Med Sci Monit. 2009 Jun;15(6):RA125-36. (PMID: 19478716)
Biomed Res Int. 2014;2014:578974. (PMID: 24678510)
Acta Med Port. 2011 Sep-Oct;24(5):809-20. (PMID: 22525634)
BMJ Open. 2023 Jun 28;13(6):e070561. (PMID: 37380206)
BMJ Open. 2020 May 26;10(5):e037256. (PMID: 32461299)
Eur Radiol. 2005 Apr;15(4):749-54. (PMID: 15627181)
J Am Coll Cardiol. 2018 Jun 26;71(25):2880-2889. (PMID: 29929610)
Radiology. 2005 Jun;235(3):843-9. (PMID: 15845795)
Pak J Med Sci. 2020 May-Jun;36(4):668-672. (PMID: 32494253)
Lancet. 2014 May 24;383(9931):1786-8. (PMID: 24856014)
Radiology. 2021 Jan;298(1):28-35. (PMID: 33170103)
Clin Chem Lab Med. 2018 Jul 26;56(8):1269-1276. (PMID: 29672267)
Crit Care Clin. 2005 Apr;21(2):261-80. (PMID: 15781162)
Nat Rev Nephrol. 2017 Mar;13(3):169-180. (PMID: 28138128)
Arthritis Res Ther. 2019 Nov 8;21(1):229. (PMID: 31703711)
AJR Am J Roentgenol. 2022 Sep;219(3):462-470. (PMID: 35383485)
Radiology. 2013 Apr;267(1):94-105. (PMID: 23360737)
Kidney Int. 2015 Jan;87(1):62-73. (PMID: 25317932)
PLoS One. 2017 Apr 20;12(4):e0175688. (PMID: 28426688)
Adv Chronic Kidney Dis. 2020 Jan;27(1):31-37. (PMID: 32146999)
Emerg Med J. 2013 Jul;30(7):555-8. (PMID: 22833599)
Acta Med Iran. 2013;51(12):871-8. (PMID: 24442542)
Radiology. 2020 Mar;294(3):660-668. (PMID: 31961246)
Circ Cardiovasc Interv. 2017 Jan;10(1):e004742. (PMID: 28049623)
Curr Opin Nephrol Hypertens. 2015 Mar;24(2):145-53. (PMID: 25602516)
Diagnostics (Basel). 2020 May 02;10(5):. (PMID: 32370193)
NPJ Digit Med. 2019 Jun 25;2:58. (PMID: 31304404)
J Nephrol. 2018 Dec;31(6):797-812. (PMID: 29802583)
Medicina (Kaunas). 2021 Nov 02;57(11):. (PMID: 34833412)
Medicine (Baltimore). 2019 Jun;98(25):e15962. (PMID: 31232927)
Nephrol Dial Transplant. 1994;9 Suppl 4:130-4. (PMID: 7800246)
Saudi J Kidney Dis Transpl. 2018 Jan-Feb;29(1):1-9. (PMID: 29456202)
BMJ. 2002 Oct 26;325(7370):917-8. (PMID: 12399325)
Pediatr Nephrol. 1997 Dec;11(6):768-72. (PMID: 9438663)

0 (Contrast Media)
AYI8EX34EU (Creatinine)

Date Created: 20250313 Date Completed: 20250513 Latest Revision: 20250513

20250513

PMC11906086

10.1371/journal.pone.0316604

40080490