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Table 1 Studies comparing the incidence of acute kidney injury between patients exposed and unexposed to intravenous contrast medium in various acute care settings

From: Iodinated contrast medium: Is there a re(n)al problem? A clinical vignette-based review

Reference Setting/design Contrast group (patients) Control group (patients) Additional means to delineate the renal risk attributable to contrast medium Comments
Polena et al. [67] ICU,
Retrospective cohort (single-centre)
N = 75
AKI: 18.6%
N = 75
AKI: 2%
None  
Tremblay et al. [68] Trauma centre;
Retrospective cohort (single-centre)
N = 56
AKI: 3%
N = 39
AKI: 16%
None Proportion of ICU patients unclear
Oleinik et al. [69] ED, patients with intracerebral haemorrhage;
Retrospective cohort (single-centre)
N = 368
AKI: 6%
OR 1.4 (95%CI 0.6–3.2)
N = 130
AKI: 14%
Multivariate regression Proportion of ICU patients unclear
Lima et al. [70] Stroke patients;
Retrospective cohort (single-centre)
N = 575
AKI: 5%
OR 0.42 (95%CI 0.24–0.71)
N = 343
AKI: 10%
Multivariate regression Proportion of ICU patients unclear
Aulicky et al. [71] Stroke patients;
Retrospective cohort (single-centre)
N = 164
AKI: 3%
N = 77
AKI: 4%
Multivariate regression Proportion of ICU patients unclear
Mc Gillicuddy et al. [72] Trauma centre, elderly trauma patients;
Retrospective cohort (single-centre)
N = 822
AKI: 1.9%
N = 249
AKI: 2.4%
None Proportion of ICU patients unclear
Ng et al. [73] ICU patients (oncology);
Retrospective cohort (single-centre)
N = 81
AKI: 17%
N = 81
AKI: 17%
1-to-1 matching on baseline serum creatinine, SOFA score and age  
Cely et al. [19] ICU;
Prospective cohort (single-centre)
N = 53
AKI: 9.4%
N = 53
AKI: 15%
1-to-1 matching on baseline creatinine clearance, diabetes, mechanical ventilation, vasopressor use  
Sinert et al. [74] ED patients with normal renal function;
Retrospective cohort (2 centres)
N = 773
AKI: 5.7%
N = 2956
AKI: 9.0%
None  
Kim et al. [75] ICU, trauma patients;
Retrospective cohort (single-centre)
N = 389
AKI: 30%
OR 0.99 (CI 95% 0.78–1.25)
N = 182
AKI: 29%
None  
Ehrmann et al. [20] ICU;
Prospective cohort (2 centres)
N = 146
AKI: 5.5%
N = 146
AKI: 5.5%
1-to-1 propensity score matching**  
Christ et al. [76] ICU patients after cardiac arrest;
Retrospective cohort
N = 89
AKI: 15.7%
N = 53
AKI: 37.7%
None  
Gao et al. [77] ICU;
Retrospective cohort (single-centre)
N = 474
AKI: 14.8%
OR 1.66 (95% CI 0.72–3.90)
N = 1,896
AKI: 12.4%
Multivariate regression  
Sonhaye et al. [78] ED;
Prospective cohort (single-centre)
N = 620
AKI: 3%
OR: 95%CI is missing
N = 672
AKI: 2%
Multivariate regression Proportion of patients admitted to the ICU unclear
Heller et al. [79] ED patients admitted to the hospital;
Retrospective cohort (single-centre)
N = 6954
AKI: 8.6%
N = 909
AKI: 9.6%
None 8% of patients admitted to the ICU
McDonald et al. [16] ICU;
Retrospective cohort (single-centre)
N = 1223 with eGFR > 45
AKI: 31%
OR 1.21 (CI 95% 0.87–1.68)
N = 285 with eGFR ≤ 45
AKI: 50%
OR 0.88 (CI95% 0.75–1.05)
N = 1223 with eGFR > 45
AKI: 34%
N = 285 with eGFR ≤ 45
AKI: 45%
1-to-1 propensity score matching** An increased risk of dialysis was observed in patients with pre-contrast eGFR ≤ 45 ml/min/1.73 m2
Hinson et al. [25] ED patients admitted to the hospital;
Retrospective cohort (single-centre)
N = 7,201
AKI: 6.8%
OR 1.00 (95% CI 0.99–1.01)
N = 10,733
AKI: 8.5%
1-to-1 propensity-score matching** ED critical care designation in 9% of patients
Proportion of patients admitted to the ICU unclear
Miyamoto et al. [17] ICU, patients with sepsis-associated AKI receiving continuous RRT;
Retrospective cohort (national database)
N = 3485
Composite outcome (in-hospital death or RRT dependence at discharge):
49.6%
OR 0.98 (95% CI 0.88–1.07)
RRT dependence at discharge: 4.4%
OR 1.08 (95% CI 0.85–1.31) median duration of RRT: 4 [IQR 2–11] days
N = 3485
Composite outcome (in-hospital death or RRT dependence at discharge):
50.2%
RRT dependence at discharge: 4.1% median duration of RRT: 4 [IQR 2–11] days
1-to-1 propensity score matching**  
Shih et al. [80] ICU (subgroup analysis), patients with CKD;
Retrospective cohort (national database)
N = 51
30-day RRT: 25.5%
aHR 0.95 (95% CI 0.44–2.05)
N = 176
30-day RRT: 25.6%
Cox proportional hazard model adjusted for age, sex and comorbid conditions Analysis of the Taiwan National Health Insurance Research Database
Goto et al. [81] ICU (patients with sepsis and AKI);
Retrospective cohort (single-centre)
N = 100 further deterioration of renal function = 34% N = 100 further deterioration of renal function = 35% 1-to-1 propensity score matching**  
Hinson et al. [82] ED, patients with sepsis;
Retrospective cohort (single-centre)
N = 1464
AKI: 7.2
OR 0.99 (95% CI 0.97–1.02)
N = 2707
AKI: 9.6%
1-to-1 propensity score matching** ED critical care designation in 4% of patients
Proportion of patients admitted to the ICU unclear
McGaha et al. [83] Paediatric trauma centre, severely injured patients;
Retrospective cohort (single-centre)
N = 164
AKI: 7.3%
N = 47
AKI: 8.5%
None 57% of patients admitted to the ICU
Williams et al. [18] ICU;
Retrospective cohort (6-hospital health system)
N = 2306
AKI: 19.3%
OR 1.11 (95% CI 0.95–1.29)
N = 2306
AKI: 18.0%
1-to-1 propensity score matching**  
  1. ICU intensive care unit, AKI acute kidney injury*, Contrast iodinated contrast media, OR odds ratio, SOFA sequential organ failure assessment, 95% CI: 95% confidence interval, eGFR estimated glomerular filtration rate, ED emergency department, RRT renal replacement therapy, IQR interquartile range, CKD chronic kidney disease, aHR adjusted hazard ratio, DRF deterioration of kidney function
  2. *The definition for AKI may differ from one study to another. This may, in part, account for the between-studies discrepancies in the reported incidence for AKI
  3. **Patients exposed and patients unexposed to contrast were matched on their propensity to be administered contrast. This approach aims at mimicking randomization in an observational study design