Evidence map›Paper›PMID 36715705›Full record

ArticleIntensive care medicine2023

Renal outcomes following intravenous contrast administration in patients with acute kidney injury: a multi-site retrospective propensity-adjusted analysis.

Michael R Ehmann, Jonathon Mitchell, Scott Levin, Aria Smith, Steven Menez, Jeremiah S Hinson, Eili Y Klein

Abstract readComment
PubMed Publisher
In one paragraph

Article in Intensive care medicine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers.

0numbers the graph read from it
0cells of the map it votes in
17citing papers in PubMed
8.1field-weighted citation impact, top 2% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

17 citing papers in PubMed, 42 citations in OpenAlex.

  1. Article
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  6. Molecules (Basel, Switzerland) · 2026
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  11. No trauma-related diagnosis in emergency trauma room whole-body computer tomography of patients with inconspicuous primary survey.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2024
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  12. Review
  13. Failing kidneys: renal replacement therapies in the ICU.Trauma surgery & acute care open · 2024
    Review
  14. Article
  15. Article
  16. Article
  17. Kidney Injury in Critically Ill Patients with COVID-19 - From Pathophysiological Mechanisms to a Personalized Therapeutic Model.Journal of critical care medicine (Universitatea de Medicina si Farmacie din Targu-Mures) · 2023
    Review
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

7 authors at 2 institutions in 1 country.

Michael R EhmannDepartment of Emergency Medicine, Johns Hopkins School of Medicine, 1830 E. Monument Street, Suite 6-100, Baltimore, MD, 21287, USA. mehmann1@jhmi.edu.ORCID 0000-0002-8093-7623
Jonathon MitchellDepartment of Emergency Medicine, Johns Hopkins School of Medicine, 1830 E. Monument Street, Suite 6-100, Baltimore, MD, 21287, USA.
Scott LevinDepartment of Emergency Medicine, Johns Hopkins School of Medicine, 1830 E. Monument Street, Suite 6-100, Baltimore, MD, 21287, USA.
Aria SmithDepartment of Emergency Medicine, Johns Hopkins School of Medicine, 1830 E. Monument Street, Suite 6-100, Baltimore, MD, 21287, USA.
Steven MenezDivision of Nephrology, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD, USA.
Jeremiah S Hinson *Department of Emergency Medicine, Johns Hopkins School of Medicine, 1830 E. Monument Street, Suite 6-100, Baltimore, MD, 21287, USA.
Eili Y Klein *Department of Emergency Medicine, Johns Hopkins School of Medicine, 1830 E. Monument Street, Suite 6-100, Baltimore, MD, 21287, USA.
Johns Hopkins University · USCenter for Disease Dynamics, Economics & Policy · US

Funding

Transforming Kidney Care in the Emergency Department using Artificial Intelligence Driven Clinical Decision SupportR01HS027793 · AHRQ · JOHNS HOPKINS UNIVERSITY · PI HINSON, JEREMIAH STEPHEN, KLEIN, EILI YA'AKOV · 2020 to 2024
$2.0M
AHRQ HHS R01 HS027793AHRQ HHS R18 HS026640
6 · The paper itself

Abstract

purposeEvidence of an association between intravenous contrast media (CM) and persistent renal dysfunction is lacking for patients with pre-existing acute kidney injury (AKI). This study was designed to determine the association between intravenous CM administration and persistent AKI in patients with pre-existing AKI.

methodsA retrospective propensity-weighted and entropy-balanced observational cohort analysis of consecutive hospitalized patients ≥ 18 years old meeting Kidney Disease Improving Global Outcomes (KDIGO) creatinine-based criteria for AKI at time of arrival to one of three emergency departments between 7/1/2017 and 6/30/2021 who did or did not receive intravenous CM. Outcomes included persistent AKI at hospital discharge and initiation of dialysis within 180 days of index encounter.

resultsOur analysis included 14,449 patient encounters, with 12.8% admitted to the intensive care unit (ICU). CM was administered in 18.4% of all encounters. AKI resolved prior to hospital discharge for 69.1%. No association between intravenous CM administration and persistent AKI was observed after unadjusted multivariable logistic regression modeling (OR 1; 95% CI 0.89-1.11), propensity weighting (OR 0.93; 95% CI 0.83-1.05), and entropy balancing (OR 0.94; 95% CI 0.83-1.05). Sub-group analysis in those admitted to the ICU yielded similar results. Initiation of dialysis within 180 days was observed in 5.4% of the cohort. An association between CM administration and increased risk of dialysis within 180 days was not observed.

conclusionAmong patients with pre-existing AKI, contrast administration was not associated with either persistent AKI at hospital discharge or initiation of dialysis within 180 days. Current consensus recommendations for use of intravenous CM in patients with stable renal disease may also be applied to patients with pre-existing AKI.

Indexed as

Acute Kidney InjuryRenal DialysisAdministration, IntravenousAdolescentContrast MediaHumansRetrospective StudiesRisk FactorsContrast MediaAcute kidney injuryContrast-associated nephropathyContrast-induced nephropathyContrast media

Identifiers

PMID36715705
OpenAlexW4318478546

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.