Gellis L, et al. - In this retrospective analysis of adults with congenital heart disease (ACHD) who had catheterization at Boston Children's hospital between 1/2011 and 1/2017, researchers determined risk factors for clinically relevant contrast-induced acute kidney injury (CI-AKI) as well as assessed contrast volume to estimated glomerular filtration rate ratio (V/eGFR) as a predictor of CI-AKI following catheterization. They used a 3:1 ratio to match controls without CI-AKI with cases for calendar year of catheterization. A higher V/eGFR ratio strongly predicted clinically significant CI-AKI, especially higher risk was observed among those with a V/eGFR ≥ 2.6. Development of CI-AKI was identified as a poor prognostic indicator and was found to be related to decreased survival in this population.