IMPACT OF IODINATED CONTRAST SHORTAGE ON CONTRAST-ASSOCIATED ACUTE KIDNEY INJURY: A SINGLE CENTER EXPERIENCE

Abstract

Therapeutic Area: Kidney Disease Background: In March 2022 China imposed strict lockdown measures to contain a COVID-19 outbreak which disrupted the global supply chains of iodine contrast media (ICM). Healthcare systems implemented contrast-saving strategies to maintain their remaining ICM supplies. This study sought to determine the impact of contrast shortage on the incidence of contrast-associated acute kidney injury (CA-AKI). Methods: This was a retrospective study of 265 patients undergoing 278 percutaneous coronary interventions (PCI) during 4-month-periods prior to (9/1/2021 - 12/31/2021) and during (5/1/2022- 8/31/2022) contrast shortage at a single center. We excluded patients with same-day discharge, missing baseline or post-PCI creatinine, and patients on dialysis at the time of their PCI. The primary end point was the incidence of CA-AKI between the study periods. Results: A total of 148 and 130 PCIs were performed before and during contrast shortage, respectively. The incidence of CA-AKI significantly decreased from 11.5% in pre-contrast shortage to 4.6% during contrast shortage (p = 0.038). During the shortage, average contrast volume per PCI was significantly lower (122.8 mL ±62 vs. 88.2 mL ±45.6, p-value <0.001), while coronary imaging was significantly higher (34.3% vs. 50%, p = 0.009) compared to pre-shortage. All-cause mortality at discharge was comparable between the study periods respectively (2.79% vs. 3.28%, p = 0.895). Conclusions: The scarcity of ICM for PCI procedures in this single center experience was associated with a significant decrease in contrast volume per PCI, significant increase in the utilization of intravascular imaging, and a significant reduction in CA-AKI.