Is Intravenous Contrast Associated with Increased Risk of Acute Kidney Injury?

Background: Computed tomography (CT) is a common imaging modality used in the emergency department. Intravenous (i.v.) contrast can assist with visualization of pathology, particularly for inflammatory conditions and vascular structures. However, i.v. contrast has historically been associated with the risk of acute kidney injury (AKI). Clinical Question: Is i.v. contrast associated with an increased risk of AKI? Evidence Review: Studies retrieved included four systematic reviews and meta-analyses evaluating the use of i.v. contrast for CT and association with AKI, need for kidney replacement therapy, and mortality. These studies provide estimates of the potential association of AKI with use of i.v. contrast for CT. Conclusion: Based upon the available literature, the use of i.v. contrast for CT imaging does not seem to be associated with an increased risk of AKI.