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Journals / Anatolian Journal of Emergency Medicine / 2026 / Cilt: 9 Sayı: 3

Acute Kidney Injury After Contrast-Enhanced Computed Tomography in The Emergency Department: Incidence and Clinically Predicted Risk Factors

Acil Serviste Kontrastlı Bilgisayarlı Tomografi Sonrası Akut Böbrek Yetmezliği: İnsidans ve Klinik Olarak Öngörülen Risk Faktörleri

Ebu Sefa Cömert(Hendek State Hospital)0000-0001-9562-3873
Kaan Celik(BOLU ABANT IZZET BAYSAL UNIVERSITY)0000-0002-9664-6732
Faruk Danış(BOLU ABANT IZZET BAYSAL UNIVERSITY)0000-0001-8722-5402
Merve Ateş(Bolu Public Health Laboratory)0000-0003-0046-3892
Pages
130–134
Publication Date
2026-09-25
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AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

Conclusion: CI-AKI occurred in 13.6% of ED patients undergoing CECT; pre-procedural hypotension and atrial fibrillation were significantly associated with its development.

📌 3 Key Takeaways

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Objective & Hypothesis:Aim: This study aimed to determine the incidence of contrast-induced acute kidney injury (CI-AKI) and to identify the clinical factors associated with it in patients undergoing contrast-enhanced computed tomography (CECT) in the emergency department (ED).
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Key Findings & Data:Material and Methods: This prospective observational study, reported in accordance with the STROBE statement, enrolled 125 consecutive adults (≥18 years) who underwent CECT in the ED between October 2023 and May 2024.
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Conclusion & Impact:Conclusion: CI-AKI occurred in 13.6% of ED patients undergoing CECT; pre-procedural hypotension and atrial fibrillation were significantly associated with its development.
🔬Design:Araştırma Makalesi
📍Scope:2023 Verileri
⚙️Variables:Bilgisayarlı tomografi · kontrast ilişkili akut böbrek hasarı · acil servis

Abstract

Aim: This study aimed to determine the incidence of contrast-induced acute kidney injury (CI-AKI) and to identify the clinical factors associated with it in patients undergoing contrast-enhanced computed tomography (CECT) in the emergency department (ED). Material and Methods: This prospective observational study, reported in accordance with the STROBE statement, enrolled 125 consecutive adults (≥18 years) who underwent CECT in the ED between October 2023 and May 2024. The sample size was estimated a priori. CI-AKI was defined as an increase in serum creatinine of ≥0.5 mg/dL or ≥25% at 48–120 hours after contrast administration. Demographic, clinical, and laboratory variables were compared between patients who did and did not develop CI-AKI. Results: CI-AKI developed in 17 of 125 patients (13.6%, 95% confidence interval [CI] 8.7–20.7%). CI-AKI was not associated with age, sex, hemoglobin, diabetes, hypertension, coronary artery disease, heart failure, or contrast volume. Pre-procedural hypotension (p=0.001) and atrial fibrillation (p=0.031) were significantly associated with CI-AKI, and CI-AKI was more frequent among patients requiring intensive care unit (ICU) admission (31.6% vs 5.7%; risk difference 25.8%, 95% CI 11.5–42.0%; p=0.001), interpreted as a marker of illness severity rather than a pre-procedural predictor. Conclusion: CI-AKI occurred in 13.6% of ED patients undergoing CECT; pre-procedural hypotension and atrial fibrillation were significantly associated with its development.

Özet

Amaç: Bu çalışma, acil serviste kontrastlı bilgisayarlı tomografi (KBT) çekilen hastalarda kontrast ilişkili akut böbrek hasarının (Kİ-ABH) görülme sıklığını ve bununla ilişkili klinik faktörleri belirlemeyi amaçlamıştır. Gereç ve Yöntemler: STROBE bildirimine uygun olarak raporlanan bu prospektif gözlemsel çalışmaya, Ekim 2023–Mayıs 2024 arasında acil serviste KBT çekilen ardışık 125 erişkin (≥18 yaş) dahil edilmiştir. Örneklem büyüklüğü önceden (a priori) hesaplanmıştır. Kİ-ABH, kontrast uygulamasından 48–120 saat sonra serum kreatininde ≥0,5 mg/dL veya ≥%25 artış olarak tanımlanmıştır. Demografik, klinik ve laboratuvar değişkenleri, Kİ-ABH gelişen ve gelişmeyen hastalar arasında karşılaştırılmıştır. Bulgular: Kİ-ABH, 125 hastanın 17'sinde (%13,6; %95 güven aralığı [GA] 8,7–20,7) gelişmiştir. Kİ-ABH ile yaş, cinsiyet, hemoglobin, diyabet, hipertansiyon, koroner arter hastalığı, kalp yetmezliği ve kontrast hacmi arasında ilişki saptanmamıştır. İşlem öncesi hipotansiyon (p=0,001) ve atriyal fibrilasyon (p=0,031) Kİ-ABH ile anlamlı biçimde ilişkili bulunmuş; Kİ-ABH, yoğun bakım ünitesine (YBÜ) yatış gerektiren hastalarda daha sık görülmüştür (%31,6'ya karşı %5,7; risk farkı %25,8; %95 GA 11,5–42,0; p=0,001). Bu bulgu, işlem öncesi bir öngördürücüden çok hastalık şiddetinin göstergesi olarak yorumlanmıştır. Sonuç: Acil serviste KBT çekilen hastalarda Kİ-ABH %13,6 oranında görülmüş; işlem öncesi hipotansiyon ve atriyal fibrilasyon gelişimiyle anlamlı biçimde ilişkili bulunmuştur.

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Cite This Article

Cömert, E. S., Celik, K., Danış, F., Ateş, M. (2026). Acute Kidney Injury After Contrast-Enhanced Computed Tomography in The Emergency Department: Incidence and Clinically Predicted Risk Factors. Anatolian Journal of Emergency Medicine, Cilt: 9 Sayı: 3, 130–134. https://doi.org/10.54996/anatolianjem.1935760

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