Table 2.
Incidence of contrast-associated acute kidney injury across included studies.
| Study (Author, Year) | Sample size (n) | CA-AKI Cases (n) | Incidence (%) | Definition of CA-AKI | Timing of AKI Assessment |
|---|---|---|---|---|---|
| Aoe (2019) (43) | 461 TACE sessions (260 patients) | 21 | 4.6% | CIN defined as increase in serum creatinine ≥0.5 mg/dL or ≥25% from baseline | 24–72 h after TACE |
| Cao (2021) (42) | 103 patients | 14 | 13.6% | CIN defined as increase in serum creatinine by ≥0.5 mg/dL within 48–72 h after contrast administration | 48–72 h after TACE |
| Cho (2011) (41) | 221 TACE treatment sessions (101 patients) | 20 | 9.0% | RCIN defined as increase in serum creatinine ≥25% from baseline | 48–96 h after TACE |
| Cohen (2014) (40) | 299 patients with available AKI data | 43a | 14.4%a | AKI reported as post-TACE complication; no formal creatinine-based definition reported | Post-TACE follow-up; exact timing not reported |
| Delgado Acosta (2020) (39) | 189 patients | 20 | 10.6% | CIN defined as increase in serum creatinine >25% from baseline or absolute increase ≥0.50 mg/dL after intravascular contrast administration | Typically 48–72 h after contrast exposure during hospitalisation |
| Diprose (2019) (38) | 336 patients | 11 | 3.3% | CA-AKI defined as increase in serum creatinine ≥26.5 µmol/L or ≥1.5 × baseline serum creatinine following contrast exposure | 24–72 h after EVT |
| Hao (2014) (37) | 316 TACE procedures in 166 patients | 24 | 7.6% | AKIN criteria: absolute increase ≥26.4 µmol/L (0.3 mg/dL), ≥50% relative increase in serum creatinine, or requirement for postoperative haemodialysis | Within 72 h after TACE |
| Hayakawa (2014) (36) | 305 TACE sessions in 141 patients | 8 | 2.6% | CIN defined as increase in serum creatinine >0.5 mg/dL or >25% from baseline within 3 days after TACE without alternative cause of AKI | Postoperative day 2–3 |
| Hayashi (2020) (35) | 270 platinum-based TACE/TAI sessions in 129 patients | 15 | 5.6% | ICA cirrhosis-specific AKI criteria: increase in serum creatinine ≥0.3 mg/dL or ≥50% from baseline within 7 days after TACE/TAI | Days 1, 5, and 30 after TACE/TAI |
| Hsu (2010) (34) | 87 HCC patients with ascites undergoing first TACE session | 11 | 12.6% | ARF/CA-AKI defined as increase in serum creatinine ≥50% from baseline or absolute increase ≥0.5 mg/dL to >1.5 mg/dL within 7 days after TACE | Within 7 days after TACE |
| Huo (2004) (33) | 140 TACE treatment sessions in 140 patients | 12 | 8.6% | ARF defined as increase in serum creatinine ≥50% from baseline or absolute increase ≥0.5 mg/dL to >1.5 mg/dL within 7 days after TACE | Days 3, 6, and 9 after TACE |
| Huo (2004) (32) | 235 patients undergoing 843 TACE sessions | 56 | 23.8% | ARF defined as increase in serum creatinine ≥50% from baseline or absolute increase ≥0.5 mg/dL to >1.5 mg/dL within 7 days after TACE | Within 7 days after TACE |
| Jia (2019) (31) | 181 patients with AIS | 9 | 5.0% | AKI defined as ≥25% increase in serum creatinine from baseline at 48 h | 48 h after CTA |
| Joo (2019) (30) | 230 patients with unruptured cerebral aneurysms undergoing elective coiling | 13 | 5.6% | CIN defined as absolute increase in serum creatinine ≥0.5 mg/dL or relative increase ≥25% from baseline serum creatinine value | 48–72 h after contrast exposure |
| Kim (2018) (29) | 184 patients with CKD undergoing neuroendovascular procedures | 1 | 0.5% | CIN defined as absolute increase in serum creatinine ≥0.5 mg/dL or ≥25% rise from baseline after excluding other causes of renal impairment | 48–72 h after contrast exposure |
| Kim (2020) (28) | 176 patients undergoing elective neurointervention procedures | 17 | 9.5% | CIN defined as increase in serum creatinine >0.5 mg/dL or ≥25% from baseline in the absence of an alternative cause | Within 48 h after contrast exposure |
| Laible (2021) (27) | 1,169 patients undergoing EVT for AIS | 29 | 2.5% | PC-AKI defined as increase in serum creatinine ≥0.5 mg/dL or >25% above baseline creatinine value | Within 48 h after admission creatinine measurement |
| Lee (2017) (26) | 1,132 HCC patients undergoing cTACE | 72 | 6.4% | AKI identified using ICD-9-CM diagnostic code 584 during follow-up | During longitudinal follow-up after cTACE |
| Lee (2018) (25) | 192 patients with aSAH undergoing coil embolization | 14 | 7.3% | CI-AKI defined as increase in serum creatinine >25% or >0.5 mg/dL from baseline | Within 72 h after coil embolization |
| Mitaka (2023) (23) | 228 patients undergoing elective neuroendovascular surgery | 2 | 0.9% | Clinical CA-AKI defined using KDIGO criteria: increase in serum creatinine ≥0.3 mg/dL within 48 h, ≥1.5 × baseline serum creatinine, or urine output <0.5 mL/kg/h for 6 h | POD 0–3 after neuroendovascular surgery |
| Murakami (2016) (22) | 186 TACE sessions in 122 patients | 14 | 7.5% | CIN defined as increase in serum creatinine ≥0.5 mg/dL or ≥25% from baseline | 48–72 h after TACE |
| Myung (2020) (20) | 601 patients undergoing sequential CTA and cerebral angiography | 57 | 9.5% | PC-AKI defined as absolute increase in serum creatinine ≥0.5 mg/dL or relative increase ≥25% from baseline | Within 72 h after contrast exposure |
| Ösken (2021) (21) | 389 patients undergoing carotid artery stenting | 26 | 6.6% | CI-AKI defined as increase in serum creatinine ≥0.3 mg/dL or ≥50% from baseline according to AKIN criteria | Within 48–72 h after contrast exposure |
| Ozdogru (2025) (19) | 281 patients undergoing EVT/MT for AIS | 54 | 19.0% | CI-AKI defined as increase in serum creatinine ≥0.5 mg/dL or >25% within 48–72 h after EVT compared with baseline | Serum creatinine assessed at baseline and 48–72 h after EVT |
| Park (2008) (18) | 236 patients undergoing TACE | 24 | 10.2% | AKI defined according to AKIN criteria as absolute increase in serum creatinine ≥0.3 mg/dL or ≥50% from baseline within 48 h after TACE | Within first 48 h after TACE |
| Prasad (2014) (17) | 79 neuroendovascular procedures with contrast media dose ≥250 mL | 4 | 5.0% | CIN defined as increase in serum creatinine ≥50% above baseline or absolute increase ≥0.3 mg/dL at either 24 or 48 h after procedure | 24 and 48 h after neuroendovascular procedure |
| Ray (2013) (16) | 75 patients with SAH undergoing at least one contrast-enhanced imaging study | 3 | 4.0% | CIN defined according to KDIGO criteria as serum creatinine increase >1.5 × baseline or >0.3 mg/dL above baseline, or urine output <0.5 mL/kg/h during one 6-h block | Serum creatinine followed up to 72 h after contrast study |
| Schwarz (2026) (15) | 6,638 patients undergoing EVT for AIS | 326 | 4.9% | CA-AKI defined according to KDIGO criteria as increase in serum creatinine ≥0.3 mg/dL or ≥1.5 × baseline within 48 h after contrast administration | Within 48 h after EVT contrast exposure |
| Seki (2021) (14) | 47 patients undergoing emergency TAE for uncontrollable postpartum haemorrhage | 0 | 0% | PC-AKI defined according to ESUR Guidelines v10.0 as increase in serum creatinine >0.3 mg/dL or >1.5 × baseline within 48–72 h after intravascular contrast administration | Serum creatinine assessed 48–72 h after TAE and before discharge |
| Sharma (2013) (13) | 194 patients undergoing emergency endovascular treatment for AIS | 3 | 1.5% | CIN defined according to AKIN criteria as relative increase in serum creatinine ≥50% above baseline or absolute increase ≥0.3 mg/dL | Within 48 h after endovascular procedure |
| Si (2021) (12) | 503 consecutive TACE sessions in 284 patients with HCC | 28 | 5.6% | CIN defined as increase in serum creatinine ≥0.5 mg/dL (50 µmol/L) or ≥25% from baseline within 48–72 h after intravascular contrast administration in absence of alternative causes | Serum creatinine assessed 48–96 h after TACE |
| Sohn (2020) (11) | 347 HCC patients undergoing TACE | 37 | 11.0% | ICA-AKI criteria: increase in serum creatinine ≥0.3 mg/dL within 48 h or ≥50% increase from baseline within prior 7 days | AKI assessed at 1 day, 2 months, and 4 months after TACE |
| Soliman (2020) (10) | 106 HAE procedures in 84 patients | 11 | 10.3% | CIN defined as 25% increase above baseline serum creatinine or absolute increase ≥0.5 mg/dL within 72 h post-embolization | Within 72 h after hepatic artery embolization |
| Song (2013) (9) | 88 patients undergoing bronchial arteriography or BAE | 7 | 8.0% | CIN defined as increase in serum creatinine >25% from baseline or absolute increase ≥0.5 mg/dL | Between 48 and 96 h after bronchial arteriography or BAE |
| Tao (2017) (8) | 2015 patients with stroke undergoing cerebral angiography ± endovascular therapy | 85 | 4.2% | CI-AKI defined according to ESUR criteria as increase in serum creatinine by ≥44 μmol/L or ≥25% from baseline within 48 h after contrast exposure in absence of alternative etiology | Within 48 h after cerebral angiography |
| Xu (2025) (7) | 171 patients with haemoptysis undergoing sequential CTA and BAE | 13 | 7.6% | CA-AKI defined as increase in serum creatinine ≥26.5 μmol/L or ≥1.5 × baseline serum creatinine after contrast exposure | 24–72 h after BAE |
| Yoo (2020) (6) | 601 patients undergoing EVT for AIS | 59 | 9.8% | AKI defined according to KDIGO criteria as increase in serum creatinine ≥0.3 mg/dL within 48 h or ≥1.5 × baseline serum creatinine within 7 days | Follow-up creatinine assessed from next day to 7 days after EVT |
| Zhou (2014) (5) | 132 patients with HCC undergoing TACE | 16 | 12.1% | AKI defined according to AKIN criteria as increase in serum creatinine ≥0.3 mg/dL or ≥50% from baseline within 48 h after TACE | Serum creatinine assessed within 48 h after TACE |
Incidence (%) was calculated using the unit of analysis reported by each original study, with CA-AKI events divided by the corresponding number of patients, procedures, or treatment sessions. Some studies reported patient-level incidence, whereas others reported procedure- or treatment-session-level incidence. Where available, both the number of procedures/sessions and the number of unique patients are presented.
AIS, acute ischemic stroke; AKI, acute kidney injury; AKIN, Acute Kidney Injury Network; ARF, acute renal failure; aSAH, aneurysmal subarachnoid haemorrhage; BAE, bronchial artery embolization; CA-AKI, contrast-associated acute kidney injury; CI-AKI, contrast-induced acute kidney injury; CIN, contrast-induced nephropathy; CKD, chronic kidney disease; cTACE, conventional transarterial chemoembolization; CTA, computed tomography angiography; ESUR, European Society of Urogenital Radiology; EVT, endovascular thrombectomy; h, hour; HAE, hepatic artery embolization; HCC, hepatocellular carcinoma; ICA, International Club of Ascites; ICD-9-CM, International Classification of Diseases, Ninth Revision, Clinical Modification; KDIGO, Kidney Disease: Improving Global Outcomes; MT, mechanical thrombectomy; PC-AKI, post-contrast acute kidney injury; POD, postoperative day; RCIN, radiocontrast-induced nephropathy; SAH, subarachnoid haemorrhage; TACE, transcatheter arterial chemoembolization; TAE, transcatheter arterial embolization; TAI, transarterial infusion chemotherapy.
a
Acute kidney injury incidence derived from 43/299 patients in the Israeli and Chinese cohorts with available adverse-event data. Although a formal creatinine-based diagnostic threshold was not reported, AKI was explicitly reported as a discrete post-TACE adverse event and was therefore eligible for the primary incidence synthesis.