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Arman Mosenia, Abtin Shahlaee, Julie Schallhorn; Kidney Injury after Intravitreal Anti-Vascular Endothelial Growth Factor Injection: A Multi-Center Study Using Electronic Health Records. Invest. Ophthalmol. Vis. Sci. 2022;63(7):1321 – F0155.
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© ARVO (1962-2015); The Authors (2016-present)
An increasing number of cases of acute kidney injury (AKI) have been reported after intravitreal anti-Vascular Endothelial Growth Factor (anti-VEGF) injections. The purpose of this study was to evaluate the real-world evidence for AKI in a large cohort of patients receiving anti-VEGF therapy using routinely collected electronic health records.
De-identified data from over 6 million patients treated across University of California Health system from 2012 to 2021 were queried. All patients with a creatinine measurement within 6 months prior to and 14 days after the intervention were considered, and those with a baseline creatinine ranging from 0.4 to 4.0 were included. Rate of acute kidney injury (a rise of creatinine by 0.3 mg/dl within 48 hours or 150% within two weeks) was calculated after the patients first record of anti-VEGF injection (intervention group) or posterior segment optical coherence tomography scan without anti-VEGF injection (OCT, control group). The χ2 test was used to assess statistical significance (α = 0.05). Information on a pre-existing diagnosis of diabetes mellitus (DM) was also included.
A total of 191,211 and 9,149 unique patients in the database received OCT and intravitreal anti-VEGF, respectively. Pre- and post-intervention creatinine were available for 7,367 (control) and 347 (intervention). Baseline creatinine was similar between the two cohorts. Rate of AKI in anti-VEGF group was 2.88%, which was not significantly different from the control group (1.87%, p=0.18). Creatinine data availability was significantly higher in the subset of patients with a previous diagnosis of DM (p < 0.0001). However, in those with DM, creatinine availability was similar between the two cohorts (p = 0.06), and rate of AKI was not significantly different (Anti-VEGF: 4.76% vs OCT: 2.50%, p=0.0503).
The rate of AKI after intravitreal anti-VEGF was low and not statistically different from the control group, even in those with a prior diagnosis of DM. Future analyses will attempt to investigate whether other patient characteristics impact the risk of kidney injury in those receiving this treatment.
This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.
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