Impact of iodinated contrast shortage on contrast-associated acute kidney injury: a single center experience.

Background: In March 2022, a COVID-19 outbreak disrupted the global supply 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 to 12/31/2021) and during (5/1/2022 to 8/31/2022) contrast shortage at a single center. The primary endpoint was the incidence of CA-AKI between 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% to 4.6% during contrast shortage ( P  = 0.04). During the shortage, average contrast volume per PCI was significantly lower (123 ± 62 mL vs 88 ± 46 mL, P  < 0.001), while coronary imaging was significantly higher (34.3% vs 50%, P  = 0.009) compared to preshortage. All-cause mortality at discharge was comparable between study periods (2.8% vs 3.3%, respectively; P  = 0.90).
Conclusion: The scarcity of ICM for PCI procedures in this single-center experience was associated with a significant increase in the utilization of intravascular imaging and a significant reduction in CA-AKI.
Competing Interests: Karim Al-Azizi is a proctor and consultant for Edwards LifeSciences, a consultant and advisory board member for Medtronic, a consultant for Boston Scientific, and on a speaker’s bureau for Philips. Srinivasa Potluri is an advisory board member, proctor, and speaker for Medtronic, Boston Scientific, Abbott, and Cordis Proctor and a speaker for Edwards, Terumo, and AstraZeneca. Molly Szerlip is a proctor, speaker, and consultant for Edwards LifeSciences; an advisory board member, consultant, and proctor for Abbott Vascular; on the steering committee for Medtronic; and a speaker and consultant for Boston Scientific. Michael Mack is a trial co–principal investigator for Abbott and for Edwards Life Sciences and a trial study chair for Medtronic—all uncompensated. The other authors report no disclosures.
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