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Does Contrast-Enhanced Imaging Impair Long-Term Renal Function? Evaluation of Contrast Imaging Performed Over a One-Year Retrospective Period in Patients Hospitalized with Acute Kidney Injury from the Emergency Department

Year 2026, Volume: 16 Issue: 1, 23 - 31, 31.01.2026
https://doi.org/10.16899/jcm.1805683

Abstract

Objective: The aim of this study was to evaluate the long-term effects of contrast-enhanced imaging on renal function in patients admitted to the emergency department with a diagnosis of acute kidney injury.
Materials and Methods: This retrospective study was conducted in the emergency department of a public hospital. Medical records of 153 patients admitted between January 1, 2024, and December 31, 2024, with a diagnosis of acute kidney injury were reviewed. Patients were divided into two groups: those who underwent contrast-enhanced imaging (n=44) and those who did not (n=109). Demographic data, comorbidities, medications, laboratory parameters, hemodialysis requirements, and mortality rates were recorded. Categorical variables were analyzed using the Chi-square test, and continuous variables were assessed using Student’s t-test or Mann–Whitney U test. A p-value of <0.05 was considered statistically significant at a 95% confidence interval.
Results: The mean age of patients was 72.66 ± 14.42 years, and 58.8% were male. Hemodialysis rates were significantly higher in the contrast group compared to the non-contrast group (43.8% vs. 19.1%; p<0.05). Similarly, mortality rates were higher in the contrast group (47.6%) than in the non-contrast group (22.5%; p<0.05). However, no significant differences were observed between the two groups regarding GFR, creatinine, urea, potassium, pH, and HCO₃ levels (p>0.05). Lactate levels were significantly elevated in the contrast-exposed group (p<0.05).
Conclusion: Although mortality and hemodialysis requirements were higher in patients who underwent contrast-enhanced imaging, there were no significant differences in fundamental renal parameters. The findings suggest that contrast alone does not lead to long-term renal function deterioration; rather, comorbidities and overall clinical condition are the key determinants.

References

  • 1. Yıldız Özkan O, Eraybar S, Kaya H, Armağan E. How effective are the computerized tomography imaging prompts in the emergency department? J Contemp Med. 2019;9(3):249–254. doi:10.16899/jcm.596718
  • 2. Azzalini L, Kalra D, Bangalore S. Contrast-induced nephropathy: Updates and critical review of the literature. Eur Heart J. 2022;43(12):1159–1173. doi:10.1093/eurheartj/ehac022
  • 3. Davenport MS, Cohan RH, Khalatbari S, et al. Contrast material–induced nephrotoxicity and intravenous contrast material administration: Consensus statements from the American College of Radiology. Radiology. 2020;294(3):660–668. doi:10.1148/radiol.2019192094
  • 4. Hinson JS, Ehmann MR, Fine DM, et al. Risk of acute kidney injury after intravenous contrast media administration. Ann Emerg Med. 2017;69(5):577–586. doi:10.1016/j.annemergmed.2016.11.021
  • 5. Jin S, Wang Y, Li J, et al. Incidence and clinical impact of contrast-associated acute kidney injury: A meta-analysis. BMC Nephrol. 2023;24(1):12–24. doi:10.1186/s12882-022-03090-4
  • 6. McDonald RJ, McDonald JS, Carter RE, Katzberg RW, Kallmes DF, Williamson EE. Intravenous contrast material exposure is not an independent risk factor for dialysis or mortality. Radiology. 2022;303(2):321–329. doi:10.1148/radiol.211231
  • 7. Van der Molen AJ, Reimer P, Dekkers IA, et al. Post-contrast acute kidney injury—definition, incidence, and risk factors. Eur Radiol. 2021;31(3):1212–1220. doi:10.1007/s00330-020-07100-4
  • 8. Park SH, Lee KH, Kim JY, Lee JH, Lee HS, Kim SJ. Serum lactate as a predictor of contrast-induced nephropathy in emergency patients. Intern Emerg Med. 2020;15(7):1181–1188. doi:10.1007/s11739-019-02234-4
  • 9. Liu Y, Zhang Q, Sun Y, et al. Association between contrast media administration and mortality in patients with acute kidney injury: A meta-analysis. Clin J Am Soc Nephrol. 2021;16(4):613–623. doi:10.2215/CJN.14010820
  • 10. Weisbord SD, Palevsky PM. Contrast-associated acute kidney injury. N Engl J Med. 2019;380(22):2146–2155. doi:10.1056/NEJMra1805256
  • 11. Choudhury RP, Ahmed F, Patel J, et al. Temporal changes in renal function after contrast administration. Kidney Int Rep. 2021;6(9):2418–2427. doi:10.1016/j.ekir.2021.06.026
  • 12. KDIGO Clinical Practice Guideline for Acute Kidney Injury. Kidney Int Suppl. 2023;13(1):1–78. doi:10.1016/j.kisu.2022.12.001
  • 13. Kaida T, Saito T, Nakamura M, Kimura Y, Fujii H, Ishikawa S. Lactate levels and mortality in critically ill AKI patients. Crit Care Med. 2024;52(3):145–153. doi:10.1097/CCM.0000000000005861
  • 14. Wu L, Chen Z, Han J, et al. Predictive factors for contrast-associated AKI in emergency CT: A prospective study. Emerg Radiol. 2025;32(1):91–100. doi:10.1007/s10140-024-02101-9
  • 15. Zhang J, Li H, Zhao M, et al. Impact of comorbidities on mortality after CA-AKI in elderly patients. Clin Exp Nephrol. 2023;27(2):155–163. doi:10.1007/s10157-022-02219-3
  • 16. Brar SS, Dangas G, Mehran R, et al. Hydration strategies for prevention of contrast-associated acute kidney injury. J Am Coll Cardiol. 2021;78(11):1081–1091. doi:10.1016/j.jacc.2021.06.035
  • 17. KDIGO Work Group. Clinical management of CA-AKI: 2024 update. Kidney Int Rep. 2024;9(2):301–315. doi:10.1016/j.ekir.2023.11.005
  • 18. Lee H, Choi JY, Kang H, Kim J, Kim H, Lee J. Safety of low-osmolar contrast agents in patients with impaired renal function. J Clin Med. 2021;10(8):1785. doi:10.3390/jcm10081785

Kontrastlı Görüntüleme Uzun Dönemde Böbrek Fonksiyonlarını Bozar mı? Acil Servisten Akut Böbrek Yetmezliği Tanısı ile Yatırılan Hastalarda Bir Yıllık Geriye Dönük Süreçte Yapılan Kontrastlı Görüntülemelerin Değerlendirilmesi

Year 2026, Volume: 16 Issue: 1, 23 - 31, 31.01.2026
https://doi.org/10.16899/jcm.1805683

Abstract

Amaç: Bu çalışmanın amacı, acil servisten akut böbrek yetmezliği tanısı ile yatırılan hastalarda kontrastlı görüntüleme uygulamasının böbrek fonksiyonları üzerindeki uzun dönemde görülen etkilerini değerlendirmektir.
Gereç ve Yöntem: Bu çalışma retrospektif olarak bir devlet hastanesi acil servisinde yapıldı. Çalışmada 01.01.2024-31.12.2024 tarihleri arasında acil servisten akut böbrek yetmezliği tanısı ile hastaneye yatırılan toplam 153 hastanın dosya kayıtları geriye dönük olarak incelendi. Hastalar kontrastlı görüntüleme yapılan (n=44) ve yapılmayan (n=109) olmak üzere iki gruba ayrıldı. Demografik veriler, ek hastalıklar, kullanılan ilaçlar, laboratuar bulguları, hemodiyaliz gereksinimi ve mortalite oranları kaydedildi. Kategorik değişkenler için Ki-kare testi ve sürekli değişkenler için Sudent T testi veya Mann-Whitnay U testi kullanıldı. Yüzde 95 güven aralığında p<0,05 anlamlı kabul edildi.
Bulgular: Hastaların yaş ortalaması 72,66 ± 14,42 yıl olup %58,8’i erkekti. Kontrastlı görüntüleme yapılan grupta hemodiyaliz oranı (%43,8) kontrastsız gruba göre anlamlı olarak daha yüksekti (%19,1; p<0,05). Benzer şekilde mortalite oranı kontrastlı grupta %47,6 iken kontrastsız grupta %22,5 olarak bulundu (p<0,05). Ancak GFR, kreatinin, üre, potasyum, pH ve HCO₃ değerleri açısından iki grup arasında anlamlı fark saptanmadı (p>0,05). Laktat düzeyi kontrast uygulanan grupta anlamlı derecede yüksekti(p<0,05).
Sonuç: Kontrastlı görüntüleme yapılan hastalarda mortalite ve diyaliz oranlarının artmış olmasına karşın, temel renal parametrelerde belirgin fark saptanmamıştır. Bulgular, kontrastın tek başına uzun dönem böbrek fonksiyon bozulmasına neden olmadığını, eşlik eden hastalık yükü ve klinik tablonun belirleyici olduğunu göstermektedir.

References

  • 1. Yıldız Özkan O, Eraybar S, Kaya H, Armağan E. How effective are the computerized tomography imaging prompts in the emergency department? J Contemp Med. 2019;9(3):249–254. doi:10.16899/jcm.596718
  • 2. Azzalini L, Kalra D, Bangalore S. Contrast-induced nephropathy: Updates and critical review of the literature. Eur Heart J. 2022;43(12):1159–1173. doi:10.1093/eurheartj/ehac022
  • 3. Davenport MS, Cohan RH, Khalatbari S, et al. Contrast material–induced nephrotoxicity and intravenous contrast material administration: Consensus statements from the American College of Radiology. Radiology. 2020;294(3):660–668. doi:10.1148/radiol.2019192094
  • 4. Hinson JS, Ehmann MR, Fine DM, et al. Risk of acute kidney injury after intravenous contrast media administration. Ann Emerg Med. 2017;69(5):577–586. doi:10.1016/j.annemergmed.2016.11.021
  • 5. Jin S, Wang Y, Li J, et al. Incidence and clinical impact of contrast-associated acute kidney injury: A meta-analysis. BMC Nephrol. 2023;24(1):12–24. doi:10.1186/s12882-022-03090-4
  • 6. McDonald RJ, McDonald JS, Carter RE, Katzberg RW, Kallmes DF, Williamson EE. Intravenous contrast material exposure is not an independent risk factor for dialysis or mortality. Radiology. 2022;303(2):321–329. doi:10.1148/radiol.211231
  • 7. Van der Molen AJ, Reimer P, Dekkers IA, et al. Post-contrast acute kidney injury—definition, incidence, and risk factors. Eur Radiol. 2021;31(3):1212–1220. doi:10.1007/s00330-020-07100-4
  • 8. Park SH, Lee KH, Kim JY, Lee JH, Lee HS, Kim SJ. Serum lactate as a predictor of contrast-induced nephropathy in emergency patients. Intern Emerg Med. 2020;15(7):1181–1188. doi:10.1007/s11739-019-02234-4
  • 9. Liu Y, Zhang Q, Sun Y, et al. Association between contrast media administration and mortality in patients with acute kidney injury: A meta-analysis. Clin J Am Soc Nephrol. 2021;16(4):613–623. doi:10.2215/CJN.14010820
  • 10. Weisbord SD, Palevsky PM. Contrast-associated acute kidney injury. N Engl J Med. 2019;380(22):2146–2155. doi:10.1056/NEJMra1805256
  • 11. Choudhury RP, Ahmed F, Patel J, et al. Temporal changes in renal function after contrast administration. Kidney Int Rep. 2021;6(9):2418–2427. doi:10.1016/j.ekir.2021.06.026
  • 12. KDIGO Clinical Practice Guideline for Acute Kidney Injury. Kidney Int Suppl. 2023;13(1):1–78. doi:10.1016/j.kisu.2022.12.001
  • 13. Kaida T, Saito T, Nakamura M, Kimura Y, Fujii H, Ishikawa S. Lactate levels and mortality in critically ill AKI patients. Crit Care Med. 2024;52(3):145–153. doi:10.1097/CCM.0000000000005861
  • 14. Wu L, Chen Z, Han J, et al. Predictive factors for contrast-associated AKI in emergency CT: A prospective study. Emerg Radiol. 2025;32(1):91–100. doi:10.1007/s10140-024-02101-9
  • 15. Zhang J, Li H, Zhao M, et al. Impact of comorbidities on mortality after CA-AKI in elderly patients. Clin Exp Nephrol. 2023;27(2):155–163. doi:10.1007/s10157-022-02219-3
  • 16. Brar SS, Dangas G, Mehran R, et al. Hydration strategies for prevention of contrast-associated acute kidney injury. J Am Coll Cardiol. 2021;78(11):1081–1091. doi:10.1016/j.jacc.2021.06.035
  • 17. KDIGO Work Group. Clinical management of CA-AKI: 2024 update. Kidney Int Rep. 2024;9(2):301–315. doi:10.1016/j.ekir.2023.11.005
  • 18. Lee H, Choi JY, Kang H, Kim J, Kim H, Lee J. Safety of low-osmolar contrast agents in patients with impaired renal function. J Clin Med. 2021;10(8):1785. doi:10.3390/jcm10081785
There are 18 citations in total.

Details

Primary Language English
Subjects Emergency Medicine, Nefroloji
Journal Section Research Article
Authors

Mustafa Alpaslan 0000-0003-3170-0125

Mehmet Polat 0000-0003-1952-4237

Submission Date October 17, 2025
Acceptance Date January 10, 2026
Publication Date January 31, 2026
Published in Issue Year 2026 Volume: 16 Issue: 1

Cite

AMA Alpaslan M, Polat M. Does Contrast-Enhanced Imaging Impair Long-Term Renal Function? Evaluation of Contrast Imaging Performed Over a One-Year Retrospective Period in Patients Hospitalized with Acute Kidney Injury from the Emergency Department. J Contemp Med. January 2026;16(1):23-31. doi:10.16899/jcm.1805683