4168 RISK FACTORS FOR POST-CONTRAST AKI IN PATIENTS MIXEDLY ADMINISTERED BOTH IODINE- AND GADOLINIUM-BASED CONTRAST MEDIA ON VISITING EMERGENCY ROOM

Abstract Background and Aims This study aimed to investigate the incidence of post-contrast acute kidney injury (PC-AKI) and its risk factor in patients administered iodine-based contrast media alone and mixed use of iodine-based contrast media and gadolinium-based contrast media. Method This retrospective study analyzed the data from 2016 to 2021. Patients who had end-stage of renal disease or missing data for estimating renal function were excluded. The primary outcome was the development of PC-AKI, i.e., an increase in creatinine of ≥25% or 0.5 mg/dL over the baseline or reduction in eGFR of ≥25% within 72 h. We compared the primary outcomes between the iodine-based contrast media alone and Mixed groups using a propensity score matching (PSM) analysis, and its risk factors were assessed from multivariable logistic regression. Results Of the 29,635 patients administrated iodine-based contrast media, 6,318 were included. There were 139 patients who mixedly administered iodine-based contrast media and GBCA. Mixed group showed significant higher rate of development of PC-AKI compared with iodine-based contrast media alone group in total cohort (adjusted OR, 3.09 [95% CI, 2.09 – 4.58]) and PSM cohort (adjusted OR, 2.38 [95% CI, 1.25 – 4.55]). On multivariate analysis to investigate risk factors in Mixed group, osmolality (adjusted aOR, 1.05 [95% CI, 1.01–1.10]) and eGFR (adjusted OR, 0.931; 95% CI, 0.883–0.983) were associated with PC-AKI. Conclusion Mixed administration of iodine-based contrast media and GBCA on same day at ED visit may be a risk factor for PC-AKI compared with single administration of iodine-based contrast media alone. Osmolality and eGFR may be independently associated with PC-AKI after mixed administration of iodine-based contrast media and GBCA