Incidence of radiocontrast nephropathy in patients undergoing acute stroke computed tomography angiography

被引:91
作者
Krol, Andrea L.
Dzialowski, Imanuel
Roy, Jayanta
Puetz, Volker
Subramaniam, Suresh
Coutts, Shelagh B.
Demchuk, Andrew M.
机构
[1] Foothills Prov Gen Hosp, Family MR Ctr, Calgary Hlth Reg, Seaman Family MR Res Ctr, Calgary, AB T2N 2T9, Canada
[2] Univ Calgary, Dept Clin Neurosci, Calgary, AB T2N 1N4, Canada
[3] Natl Neurosci Ctr, Kolkata, W Bengal, India
[4] Univ Dresden, Dept Neurol, Dresden, Germany
关键词
CT angiography; digital subtraction angiography; radiocontrast nephropathy; renal impairment;
D O I
10.1161/STROKEAHA.107.482778
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Background and Purpose - Minimal research has evaluated the renal safety of emergent computed tomography angiography (CTA) procedures, consecutive contrast medium application, and the long-term outcome in acute stroke patients. We investigated the incidence of contrast-induced renal impairment in these populations. Methods - We retrospectively reviewed patients with acute stroke syndrome who received a CTA of the brain with or without the neck within 24 hours from onset of symptoms. All creatinine results and additional conventional angiography findings were recorded. With a positive history of renal disease, contrast administration was delayed until creatinine results were available. Radiocontrast nephropathy (RCN) was defined as a >= 25% increase in serum creatinine from the baseline value up to 5 days after CTA. Results - Four hundred eighty-one patients were reviewed, and 224 met the inclusion criteria. There were 7 of 224 (3%) who fulfilled the criteria for RCN. A number of patients underwent emergent CTA without knowledge of their creatinine value; 2 of 93 (2%) developed RCN. There were 36 patients who received an additional digital subtraction angiogram, and none of these developed subsequent RCN. No patients required dialysis, and 9 of 68 (13%) had a >= 25% increase in their creatinine levels at a late (> 30 days) follow-up. Conclusions - Overall, these results illustrate that there is a low incidence of RCN in acute stroke patients undergoing emergency CTA.
引用
收藏
页码:2364 / 2366
页数:3
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