Incidence of radiocontrast nephropathy in patients undergoing acute stroke computed tomography angiography.
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.
Krol
Andrea L
AL
Dzialowski
Imanuel
I
Roy
Jayanta
J
Puetz
Volker
V
Subramaniam
Suresh
S
Coutts
Shelagh B
SB
Demchuk
Andrew M
AM
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*
D003287:Contrast Media; D003404:Creatinine