# How Does Contrast Administration Influence Creatinine Dynamics in Trauma Patients With Acute Kidney Injury?

## TL;DR

This study examines how contrast administration affects creatinine levels in trauma patients with acute kidney injury and finds that these changes don't reliably predict clinical outcomes.

## Contribution

The study is the first to evaluate the relationship between contrast-induced creatinine variability and clinical outcomes in trauma-related AKI.

## Key findings

- Creatinine changes after contrast administration showed significant variability but were not linked to hospital length of stay.
- No significant association was found between contrast-induced creatinine changes and dialysis requirements or mortality.
- The study suggests that creatinine alone has limited predictive value for clinical outcomes in trauma-induced AKI.

## Abstract

Background

Acute kidney injury (AKI) is a serious complication frequently encountered among trauma patients, with incidence rates varying significantly depending on injury severity and diagnostic interventions such as contrast-enhanced imaging. Serum creatinine (Cr) is commonly used to assess renal function; however, its variability following contrast administration and the implications for clinical outcomes in trauma-related AKI remain poorly defined. This study aimed to evaluate the variability of Cr changes from admission to AKI diagnosis following contrast-enhanced CT and their relationship with clinical outcomes such as hospital length of stay (LoS), dialysis requirements, and mortality in trauma patients.

Methods

A retrospective analysis was conducted on adult trauma patients admitted to a Level 1 trauma center who developed AKI after receiving intravenous iodinated contrast during CT scans within 24 hours of admission. Patients with end-stage renal disease (ESRD), advanced chronic kidney disease, pre-admission dialysis, or incomplete baseline Cr data were excluded. Cr changes were calculated from admission to AKI diagnosis. Associations between Cr changes and clinical outcomes, including LoS, dialysis requirements, and mortality, were assessed using statistical methods.

Results

Cr changes showed significant variability, ranging from -1.6 mg/dL to 5.7 mg/dL. However, no statistically significant association was found between contrast-induced Cr changes and hospital LoS, dialysis requirements, or mortality (p > 0.05). These results suggest that Cr fluctuations following contrast administration alone do not reliably predict clinical outcomes.

Conclusion

While Cr changes remain useful for assessing kidney function following trauma and contrast administration, this measure alone has limited predictive value for clinical outcomes in trauma-induced AKI. A more comprehensive approach, incorporating additional clinical factors and novel biomarkers, is necessary for accurate risk stratification and effective management. Future studies should explore integrated assessment tools to improve early detection and personalized management of AKI in trauma patients exposed to contrast-enhanced imaging.