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

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.

Keywords

• Contrast media
• acute kidney injury
• contrast-associated nephropathy
• hemodialysis
• mortality

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

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.

Keywords

• Kontrast madde
• akut böbrek yetmezliği
• kontrast ilişkili nefropati
• hemodiyaliz
• mortalite

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