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Contrast-Associated Acute Kidney Injury in Trauma

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Trauma Computed Tomography

Abstract

Hospitalized patients are at an increased risk of acute kidney injury. Patients presenting with trauma-related injuries present unique risk factors to increase risk for kidney injury due to hemodynamic factors, crush injuries, and inflammatory mediators. The risk in these patients is additionally mediated by nephrotoxic medications, including non-ionic contrast administration for contrast-enhanced computed tomography scans. The evidence base for contrast-associated acute kidney injury is confounded by varying inclusion and exclusion criteria, prophylactic measures used, and outcome assessment. The risk of contrast-associated acute kidney injury is likely greatest in those who have estimated glomerular filtration <30 mL/min/1.73 m2 or 30–45 mL/min/1.73 m2 with additional risk factors. The most evidence-based approach for prevention of contrast-associated kidney injury is through isotonic intravenous fluid administration, which should be employed in patients at highest risk of kidney injury who require contrast administration.

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Abbreviations

AKI:

Acute kidney injury

CA-AKI:

Contrast-associated acute kidney injury

CECT:

Contrast-enhanced computed tomography

CI-AKI:

Contrast-induced acute kidney injury

CIN:

Contrast-induced nephropathy

CKD:

Chronic kidney disease

CT:

Computed tomography

DM:

Diabetes mellitus

eGFR:

Estimated glomerular filtration rate

KDIGO:

Kidney disease improving global outcomes

NaCl:

Sodium chloride

SCr:

Serum creatinine

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Author information

Authors and Affiliations

  1. Renal-Electrolyte and Hypertension Division, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA

    Michael R. Rudnick & Ryan Spiardi

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  1. Michael R. Rudnick
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  2. Ryan Spiardi
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Correspondence to Michael R. Rudnick .

Editor information

Editors and Affiliations

  1. Department of Medical Imaging, Penn Presbyterian Medical Center, Philadelphia, PA, USA

    Friedrich Knollmann

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Rudnick, M.R., Spiardi, R. (2023). Contrast-Associated Acute Kidney Injury in Trauma. In: Knollmann, F. (eds) Trauma Computed Tomography. Springer, Cham. https://doi.org/10.1007/978-3-031-45746-3_13

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  • DOI: https://doi.org/10.1007/978-3-031-45746-3_13

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-031-45745-6

  • Online ISBN: 978-3-031-45746-3

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