Objective:

To investigate the association between venous congestion and contrast-associated acute kidney injury (CA-AKI) and to determine if venous congestion is a stronger predictor of CA-AKI than low cardiac output in patients with cardiovascular diseases.

Approach:

Key Findings:

• CA-AKI occurred in 19% of patients overall, with the highest incidence in the congested group (24%).
• Congested patients had a significantly greater risk of CA-AKI compared to controls (Hazard Ratio (HR): 1.49, p = 0.001).
• Low-output patients showed only a trend towards increased risk of CA-AKI (HR: 1.22, p = 0.059).
• In multivariate analysis, only venous congestion was independently associated with AKI (HR for 5 mmHg increase in RAP: 1.07, p = 0.034).

Interpretation:

Limitations:

• The study is retrospective and conducted at a single center, which may limit generalizability.
• Exclusion criteria may have led to selection bias, as patients with chronic need for hemodialysis were excluded.

Conclusion:

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