Association Between Acute Kidney Disease and Intravenous Dye Administration in Patients With Acute Stroke: A Population-Based Study

作者：Demel Stacie L^*; Grossman Aaron W; Khoury Jane C; Moomaw Charles J; Alwell Kathleen; Kissela Brett M; Woo Daniel; Flaherty Matthew L; Ferioli Simona; Mackey Jason; la Rosa Felipe De Los Rios; Martini Sharyl; Adeoye Opeolu; Kleindorfer Dawn O

来源：Stroke, 2017, 48(4): 835-839.

DOI：10.1161/STROKEAHA.116.014603

• acute kidney injury
• contrast media
• diagnostic imaging
• epidemiology
• stroke

Background and Purpose-Computed tomographic angiography and conventional angiography provide timely vascular anatomic information in patients with stroke. However, iodinated contrast dye may cause acute kidney injury (AKI). Within a large, biracial population, we examined in-hospital incidence of new or worsening kidney disease in patients with stroke and its association with administration of intravenous dye.
Methods-All adult residents of the Greater Cincinnati/Northern Kentucky region with acute ischemic stroke or intracerebral hemorrhage who presented to an emergency department in 2010 were included. Prevalence of unsuspected kidney disease at the time of emergency department presentation and the incidence of AKI after admission in 2 groups of patientsthose who did and those who did not receive intravenous dyewere determined.
Results-In 2010, 2299 patients met inclusion criteria (89% ischemic stroke and 11% intracerebral hemorrhage); mean age 69 years (SD 15), 22% black, and 54% women. Among these patients, 37% had kidney disease at baseline, including 22% (516/2299) in whom this was unsuspected. Two percent (2%; 15/853) of patients with baseline kidney disease developed AKI during the hospital stay. Of those with no baseline kidney disease, 1% (14/14467) developed AKI. There was no association between dye administration and new or worsening kidney disease.
Conclusions-Although 22% of patients in the Greater Cincinnati/Northern Kentucky stroke population had unsuspected kidney disease, the incidence of new or worsening kidney disease was low, and AKI was not associated with dye administration. These findings confirm single-center reports that the risk of severe renal complications after contrast dye is small.

• 出版日期2017-4