From the Neurology unit (Asiri, Alharbi, Aqeeli, Alzahrani, Alwadai), Department of Medicine, King Fahad hospital, Jeddah, from the Neurology unit (Alqahtani M), Department of Medicine, Armed Forces Hospital-Southern Region, Khamis Mushait, and from the Unit of Neurology (Alqahtani S), College of Medicine, King Khalid University, Abha, Kingdom of Saudi Arabia.
Neurosciences (Riyadh). 2023 Oct;28(4):258-263. doi: 10.17712/nsj.2023.4.20230030.
To investigate the prevalence and risk factors linked to contrast-induced nephropathy in this specific patient population, aiming to ensure the highest quality of clinical care.
In a retrospective analysis, all patients who presented with an acute stroke to King Fahad Hospital, Jeddah, Emergency Department from March until November 2022 and underwent Computed Tomography Angiography (CTA) brain, Inclusion criteria were as follows: a baseline creatinine results and CTA examination performed within 24 hours of symptom onset and an available early (<5 days after CTA) follow-up creatinine result.
Among 246 stroke patients in the emergency, 182 underwent brain CTA and 8.24% had Contrast-Induced Nephropathy (CIN). intracerebral hemorrhage (ICH) increased CIN risk 7-fold (OR=6.7; 95% CI: 1.23-33.3). Abnormal baseline raised CIN risk 8-fold (OR=7.8; 95% CI: 1.74-35.1). hypertension doubled the risk for CIN (OR=2.1; 95% CI: 1.26-6.98) CONCLUSION: The incidence of CIN was 8.2%, particularly elevated in patients with ICH, hypertension, tissue plasminogen administration, and abnormal baseline, necessitating vigilance in managing acute stroke cases.
调查该特定患者人群中与对比剂肾病相关的患病率和危险因素，旨在确保提供最高质量的临床护理。
在回顾性分析中，所有于 2022 年 3 月至 11 月期间因急性脑卒中入住吉达法赫德国王医院急诊科的患者，均进行了计算机断层扫描血管造影（CTA）脑部检查，纳入标准如下：症状发作后 24 小时内进行了基线肌酐检查和 CTA 检查，并且可以获得早期（CTA 后 <5 天）的肌酐随访结果。
在急诊科的 246 名脑卒中患者中，有 182 名患者进行了脑部 CTA 检查，其中有 8.24%的患者发生了对比剂肾病（CIN）。颅内出血（ICH）使 CIN 的风险增加了 7 倍（OR=6.7；95%CI：1.23-33.3）。基线异常使 CIN 的风险增加了 8 倍（OR=7.8；95%CI：1.74-35.1）。高血压使 CIN 的风险增加了一倍（OR=2.1；95%CI：1.26-6.98）。
CIN 的发生率为 8.2%，在 ICH、高血压、组织型纤溶酶原激活物给药和基线异常的患者中尤其升高，因此在处理急性脑卒中病例时需要保持警惕。
