Contrast use significantly increases risk of kidney injury in neonates
New research is offering updated insight into the risk iodinated contrast media poses to the kidney health of neonates in the intensive care unit.
Contrast-enhanced imaging exams can give clinicians the kind of detailed visualization needed to identify suspicious findings that might be impacting newborn babies. This information can be critical to determining the source of a neonate’s issues, which can be challenging to pinpoint in such young patients. Unfortunately, the use of contrast comes with caveats, as it can cause acute kidney injury in rare cases, with newborns especially vulnerable.
“Neonates' immature renal function may cause increased susceptibility to renal toxicity from iodinated contrast media,” Pyeong Hwa Kim, MD, PhD, with the department of radiology at the Research Institute of Radiology, University of Ulsan College of Medicine, in the Republic of Korea, and colleagues wrote Wednesday in the American Journal of Roentgenology. “However, little high-quality evidence addresses acute kidney injury risk after neonatal ICM exposure.”
The new paper discusses researchers’ recent efforts to better understand these risks. For their work, the team retrospectively analyzed the cases of neonates admitted to the ICU who underwent contrast-enhanced CT, noncontrast CT or noncontrast MRI between June 2000 and June 2023. Acute kidney injury was defined as an increase in serum creatinine of ≥0.3 mg/dL within 48 hours relative to when the exam took place immediately preceding a value of ≥50% within 7 days of the lowest preexamination value since birth. Values were used to categorize kidney injury as 1, 2 or 3, with higher figures indicating greater severity.
Upon comparison, the team noted a significant increase in acute kidney injury for the group that was given iodinated contrast media (13.9% vs 8.2%). However, these instances were most often categorized as stage 1; incidence of stage 2 and 3 acute kidney injury did not differ between those who were given ICM and those who were not.
The group suggested that their findings can be used to make risk-based decisions for future use of contrast in neonates.
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In addition to her background in journalism, Hannah also has patient-facing experience in clinical settings, having spent more than 12 years working as a registered rad tech. She began covering the medical imaging industry for Innovate Healthcare in 2021.