How common are acute kidney injuries in kids following contrast administration?
Iodinated contrast administration during various CT examinations does not significantly increase the risk of acute kidney injury (AKI) in pediatric patients [1].
In fact, compared to children who undergo CT scans sans contrast administration, children who receive the imaging agent record similar outcomes, with AKI being a rare occurrence in both groups.
This was the finding of a study published recently in the journal Radiology. In the paper, experts compared instances of AKI in children who underwent either contrast-enhanced or noncontrast CT studies. Their analysis of 19,377 scans from 10,407 patients revealed an incidence rate of just 1.4% for the children who underwent contrast-enhanced imaging. In comparison, the noncontrast group actually recorded a higher incidence rate of 1.6%.
Corresponding author of the study, Hansel J. Otero, with the Department of Radiology at the Perelman School of Medicine, University of Pennsylvania, and co-authors noted that their large sample size is beneficial in understanding the true risks associated with contrast-associated acute kidney injuries (CA-AKI), as previous studies were limited due, in part, to their small sample sizes.
“The 1.4% rate of CA-AKI in this population is lower than previously reported in children, and while the rarity of AKI limits statistical power, this large sample is beneficial in reducing the risk for a type II error,” the authors explained.
Based on their findings, the most significant CA-AKI risks occurred when patients had an estimated glomerular filtration rate lower than 60 mL/min/1.73. The incidence rate among those patients was 8.5% with contrast use. However, this was not the case in the noncontrast group.
The experts also noted that age was found to be a protective factor, with fewer instances of CA-AKI being recorded in older children.
The authors suggested that although the use of CT either with or without contrast poses such minimal risks, the risks and benefits for pediatric patients should still be weighed, especially with the availability of other modalities that do not require ionizing radiation.
“While we found an increased risk for AKI only in a subgroup analysis for exposure to contrast media, clinical importance must be assessed separately,” the authors explained.
The study abstract is available here.
In addition to her background in journalism, Hannah also has patient-facing experience in clinical settings, having spent more than 12 years working as a registered rad tech. She began covering the medical imaging industry for Innovate Healthcare in 2021.