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Post-Contrast Acute Kidney Injury after Acute Stroke—Insights from a German Tertiary Care Center

Background: Our aim was to investigate the relationship between additional iodinated contrast medium (CM) application for acute stroke imaging and Post-Contrast Acute Kidney Injury (PC-AKI). Methods: We performed a retrospective analysis of consecutive patients with acute stroke who received a CT an...

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Published in:Journal of clinical medicine 2021-12, Vol.10 (23), p.5684
Main Authors: Frank, Benedikt, Escolà, Jordi Kühne, Biermann-Ratjen, Leoni, Hüsing, Anika, Li, Yan, Dammann, Philipp, Sure, Ulrich, Kleinschnitz, Christoph, Forsting, Michael, Köhrmann, Martin, Deuschl, Cornelius
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Language:English
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Summary:Background: Our aim was to investigate the relationship between additional iodinated contrast medium (CM) application for acute stroke imaging and Post-Contrast Acute Kidney Injury (PC-AKI). Methods: We performed a retrospective analysis of consecutive patients with acute stroke who received a CT angiogram (CTA) with or without additional CT perfusion (CTP) at admission between 2017 and 2020. The primary endpoint was the incidence of PC-AKI. Potential causes of renal function impairment were recorded and logistic regression was performed to determine predictors of PC-AKI. Results: Of 3134 cases screened, n = 989 met the predefined inclusion criteria. PC-AKI occurred in 22 (5.4%) patients who received CTA only and 18 (3.1%) patients who received CTA and additional CTP (unadjusted OR, CI; 0.59, 0.29–1.05). In 31/40 (77.5%) patients who suffered PC-AKI, a non-CM-related cause of renal function impairment was identified. Stroke etiology (hemorrhagic vs. ischemic) and indicators of prior kidney disease were independent predictors of PC-AKI. Conclusions: Additional administration of CM for perfusion imaging in acute stroke did not show a relevant influence on the occurrence of PC-AKI. Patients with intracranial hemorrhage and/or prior kidney disease are at particular risk of developing AKI.
ISSN:2077-0383
2077-0383
DOI:10.3390/jcm10235684