Assessing the Risk of Acute Kidney Injury Related to Contrast Exposure in Patients of Stroke

Asim Rehmani; Quratulain Khan; Khurram Danial; Aamna Qazi; Farrukh Zulfiqar; Syed Muneeb Younus

doi:10.29054/apmc/2022.1263

Asim Rehmani Assistant Professor, Department of Neurosurgery, DUHS / Civil Hospital, Karachi Pakistan
Quratulain Khan Assistant Professor, Department of Critical Care Medicine, Ziauddin University Hospital, Karachi Pakistan
Khurram Danial Associate Professor, Department of Nephrology, Karachi Medical & Dental College, Karachi Pakistan
Aamna Qazi Consultant Physician, Department of Medicine, Jinnah Postgraduate Medical Centre, Karachi Pakistan
Farrukh Zulfiqar Assistant Professor, Department of Neurosurgery, DUHS / Civil Hospital, Karachi Pakistan
Syed Muneeb Younus Consultant Neurosurgeon, Department of Neurosurgery, KVSS Site Hospital, Karachi Pakistan

DOI: https://doi.org/10.29054/apmc/2022.1263

Keywords: Contrast medium, Kidney injury, Ischemic stroke

Abstract

Background: The computerized tomographic angiography (CTA) and the computerized tomographic perfusion (CTP) are imaging techniques that help physicians in identifying and assessing the cases of acute ischemic stroke. Studies have reported very low incidence of acute kidney injury in acute ischemic stroke patients who undergo these diagnostic modalities. Objective: To determine the incidence of AKI following administration of iodinated contrast media in patients presenting with acute ischemic stroke. Study Design: A prospective cohort study. Settings: A single large tertiary care hospital in Karachi Pakistan. Duration: A total of 18 months from Jan 2020 till June 2021. Methods: The type of study is a prospective cohort study conducted for a period of 18 months. The inclusion criteria were patients who presented to us with signs and symptoms of ischemic stroke, with no visible hemorrhage on CT scan and undergoing CT angiography. To perform the angiography procedure isotonic contrast of 1.5 ml/kg was injected at 4 ml/second. Results: A total of n= 180 patients were included in the study, of which n= 108 were males and n= 72 were female. The mean age of the patients was 66.75 ± 12.4 years. N= 86 patients were in group A with only CTA performed and n= 94 patients were included in group B where patients underwent both CTA and DSA procedures. Out of 180 patients included n= 8 patients met our criteria for the diagnosis of acute kidney injury. N= 2 of the patients were in group A and n= 6 of the patients were in group B having a p value of 0.17. The mean change in creatinine levels of diagnoses AKI patients of the two groups were recorded as 0.25 ± 0.05 mg/dL in group A and 1.70 ± 2.43 mg/dL in group B. Conclusion: Our study showed that there is no significant increase in the incidence of acute kidney injury in patients who undergo CT angiography for acute ischemic stroke.