Contrast tied to higher AKI risk in neonatal ICU study

Neonates exposed to iodinated contrast media had a higher acute kidney injury rate than those who underwent noncontrast imaging, according to a study published May 20 in American Journal of Roentgenology.

Pyeong Hwa Kim, MD, PhD, of the University of Ulsan College of Medicine, and colleagues evaluated neonates admitted to the ICU who underwent contrast-enhanced CT, noncontrast CT, or noncontrast MRI between June 2000 and June 2023.

Acute kidney injury was defined by serum creatinine change after imaging. The study classified injury severity as stage 1, 2, or 3.

Iodinated contrast media exposure was associated with a higher acute kidney injury rate, at 13.9% compared with 8.2% in the noncontrast group.

Most kidney injury cases were stage 1. Incidence of stage 2 and stage 3 acute kidney injury did not differ between neonates who received iodinated contrast media and those who did not.

Researchers used propensity-score and overlap-weighted analyses to evaluate risk after contrast exposure. The study title describes the analysis as focused on neonates in the ICU.

Study authors said the findings may help clinicians make risk-based decisions about iodinated contrast use in neonates.