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Contrast-Induced Acute Kidney Injury in Radiologic Management of Acute Ischemic Stroke in the Emergency Setting

Authors
 J W Myung  ;  J H Kim  ;  J Cho  ;  I Park  ;  H Y Kim  ;  J H Beom 
Citation
 AMERICAN JOURNAL OF NEURORADIOLOGY, Vol.41(4) : 632-636, 2020-04 
Journal Title
 AMERICAN JOURNAL OF NEURORADIOLOGY 
ISSN
 0195-6108 
Issue Date
2020-04
Abstract
Background and purpose: The use of invasive cerebral angiography with CTA for active treatment of patients with suspected ischemic strokes has been increasing recently. This study aimed to identify the incidence of postcontrast acute kidney injury using baseline renal function when CTA and cerebral angiography were performed sequentially. Materials and methods: This retrospective observational study evaluated adults (18 years of age or older) with ischemic stroke who underwent CTA and cerebral angiography sequentially between 2010 and 2018. The incidence of postcontrast acute kidney injury was determined using the baseline estimated glomerular filtration rate. The value of the baseline estimated glomerular filtration rate at which the occurrence of postcontrast acute kidney injury increased was also determined. Results: Postcontrast acute kidney injury occurred in 57/601 (9.5%) patients. Those with a baseline estimated glomerular filtration rate of <30 mL/min/1.73 m2 showed a higher incidence of acute kidney injury. Age, chronic kidney disease, medication (nonsteroidal anti-inflammatory drugs, angiotensin-converting enzyme inhibitors, angiotensin II receptor blockers, β blockers, statins, and insulin) use following contrast media exposure, and serum albumin affected the incidence of postcontrast acute kidney injury. The incidence of postcontrast acute kidney injury increased when the baseline estimated glomerular filtration rate was <43 mL/min/1.73 m2. Conclusions: Patients with low baseline renal function had the highest incidence of postcontrast acute kidney injury after CTA and cerebral angiography, but no fatal adverse effects were documented. Thus, patients suspected of having a stroke should be actively managed with respect to neurovascular function.
Files in This Item:
T202001874.pdf Download
DOI
10.3174/ajnr.A6472
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Biomedical Systems Informatics (의생명시스템정보학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Emergency Medicine (응급의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Ji Hoon(김지훈) ORCID logo https://orcid.org/0000-0002-0070-9568
Kim, Ha Yan(김하얀)
Myung, J W(명진우)
Park, In Cheol(박인철) ORCID logo https://orcid.org/0000-0001-7033-766X
Beom, Jin Ho(범진호) ORCID logo https://orcid.org/0000-0002-2805-257X
Cho, Junho(조준호) ORCID logo https://orcid.org/0000-0003-2240-3989
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/179113
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