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A growing body of evidence assuages concern about radiocontrast causing acute kidney injury (AKI). But what about patients who are critically ill — might they be more sensitive to contrast? Investigators from a six-hospital Florida healthcare system examined records of more than 4600 patients who were admitted to intensive care for at least 24 hours: Half had received intravenous low-osmolarity contrast and the other half were propensity-matched controls. Hypertension (60%) and diabetes (25%) were common; more than half of patients were overweight or obese.
Nearly 20% of patients developed AKI, which was associated with higher mortality and longer hospital length of stay. Incidence of AKI was similar in the patients who received contrast and…