title: Incidence of radiocontrast nephropathy in patients undergoing acute stroke computed tomography angiography.
abstract: OBJECTIVE
  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.
authors.forename: Andrea L
authors.initials: AL
authors.lastname: Krol
authors.forename: Imanuel
authors.initials: I
authors.lastname: Dzialowski
authors.forename: Jayanta
authors.initials: J
authors.lastname: Roy
authors.forename: Volker
authors.initials: V
authors.lastname: Puetz
authors.forename: Suresh
authors.initials: S
authors.lastname: Subramaniam
authors.forename: Shelagh B
authors.initials: SB
authors.lastname: Coutts
authors.forename: Andrew M
authors.initials: AM
authors.lastname: Demchuk
mesh_terms: D000208:Acute Disease / Q000453:epidemiology; D000368:Aged; D002533:Cerebral Angiography / Q000009:adverse effects*; D003287:Contrast Media / Q000009:adverse effects*; D003404:Creatinine / Q000097:blood; D005260:Female; D006801:Humans; D015994:Incidence; D007668:Kidney / Q000187:drug effects / Q000503:physiopathology; D007674:Kidney Diseases / Q000139:chemically induced* / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D051437:Renal Insufficiency / Q000139:chemically induced / Q000453:epidemiology; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D020521:Stroke / Q000000981:diagnostic imaging*; D014057:Tomography, X-Ray Computed / Q000009:adverse effects*
chemical_list: D003287:Contrast Media; D003404:Creatinine