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Research ArticleOriginal Article
Open Access

Incidence and risk factors of contrast-induced nephropathy in acute stroke patients undergoing computed tomography angiography: A single-center study

Muhannad A. Asiri, Mohammed S. Alqahtani, Saeed A. Alqahtani, Mohammed M. Alwadai, Naif F. Alharbi, Mohammed O. Aqeeli and Saeed S. Alzahrani
Neurosciences Journal October 2023, 28 (4) 258-263; DOI: https://doi.org/10.17712/nsj.2023.4.20230030
Muhannad A. Asiri
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
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  • ORCID record for Muhannad A. Asiri
  • For correspondence: [email protected]
Mohammed S. Alqahtani
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
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Saeed A. Alqahtani
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
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Mohammed M. Alwadai
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
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Naif F. Alharbi
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
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Mohammed O. Aqeeli
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
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Saeed S. Alzahrani
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
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    Figure 1

    - Incidence of acute stroke patients developing Contrast-Induced Nephropathy (CIN) following CT angiography brain.

Tables

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    Table 1

    - Bio-demographic characteristics of acute stroke patients developing contrast-induced nephropathy following CT angiography brain.

    DataTotalCINP-value
    YesNo
    No (%)No (%)No (%)
    Incidence of CIN18215 (8.24)167 (91.8) 
    Age in years    
    < 4014 (7.7)1 (7.1)13 (92.9).322
    40-5980 (44.0)4 (5.0)76 (95.0)
    60+88 (48.4)10 (11.4)78 (88.6)
    Gender
    Male120 (65.9)9 (7.5)111 (92.5).613
    Female62 (34.1)6 (9.7)56 (90.3)
    Risk factors
    Diabetes Mellitus93 (51.1)7 (7.5)86 (92.5).049**$
    Hypertension109 (59.9)10 (9.2)99 (90.8)
    Smoking21 (11.5)0 (0.0)21 (100.0)
    Ischemic heart disease34 (18.7)3 (8.8)31 (91.2)
    Epilepsy4 (2.2)0 (0.0)4 (100.0)
    Atrial fibrillation5 (2.7)0 (0.0)5 (100.0)
    Heart failure4 (2.2)0 (0.0)4 (100.0)
    CKD4 (2.2)2 (50.0)2 (50.0)
    Unknown38 (20.9)3 (7.9)35 (92.1)
    Large vessel occlusion
    Yes44 (24.3)4 (9.1)40 (90.9).824$
    No137 (75.7)11 (8.0)126 (92.0)
    Thrombectomy
    Yes33 (18.1)2 (6.1)31 (93.9).615$
    No149 (81.9)13 (8.7)136 (91.3)
    TPA
    Yes39 (21.4)7 (17.9)32 (82.1).013*$
    No143 (78.6)8 (5.6)135 (94.4)
    • P - Pearson X2 test,

    • ↵$ - Exact probability test

    • ↵* p<0.05 (significant),

    • CIN - Contrast Induced Nephropathy, CKD - Chronic Kidney Disease, TPA - tissue plasminogen activator

    • View popup
    Table 2

    - Multiple logistic regression analysis for predictors of developing contrast-induced nephropathy among acute stroke patients underwent brain CT angiography.

    FactorsBS.E.P-valueORA95% CI
    LowerUpper
    Age in years0.040.03.1231.040.991.10
    Male gender0.210.71.7691.230.315.10
    Diabetes Mellitus-0.670.72.3530.510.132.10
    Hypertension0.690.03.045*2.101.296.98
    Smoking-0.551.27.6640.570.056.99
    Ischemic heart disease-0.250.89.7780.780.134.48
    Large vessel occlusion0.350.93.7111.410.238.79
    Thrombectomy-0.731.04.4810.480.063.69
    TPA1.970.72.007*7.151.7329.59
    ICH1.920.87.027*6.661.2333.31
    fever-0.381.24.7600.690.067.76
    Abnormal baseline2.060.77.007*7.821.7435.11
    Seizures0.121.06.9101.130.149.07
    • B - regression coefficient, SE - Standard error, ORA - Adjusted odds ration, CI - Confidence interval,

    • ↵* p< 0.05 (significant),

    • ICH - intracerebral hemorrhage, TPA - tissue plasminogen

    • View popup
    Table 3

    - Clinical data characteristics of acute stroke patients developing contrast-induced nephropathy following CT angiography brain.

    Clinical dataTotalCINP-value
    YesNo
    No (%)No (%)No (%)
    Diagnosis
    ICH19 (10.4)4 (21.1)15 (78.9).150
    Ischemic stroke134 (73.6)10 (7.5)124 (92.5)
    Mimics9 (4.9)0 (0.0)9 (100.0)
    TIA20 (11.0)1 (5.0)19 (95.0)
    Fever 1st 48 hours
    Yes5 (2.9)0 (0.0)5 (100.0).487
    No170 (97.1)15 (8.8)155 (91.2)
    Abnormal serum creatinine baseline
    Yes21 (11.6)5 (23.8)16 (76.2).006*
    No160 (88.4)10 (6.3)150 (93.8)
    Seizures
    Yes15 (8.2)2 (13.3)13 (86.7).454
    No167 (91.8)13 (7.8)154 (92.2)
    Length of hospital stay
    1-6 days71 (39.0)4 (26.7)67 (40.1).655
    7-14 days54 (29.7)6 (40.0)48 (28.7)
    15-30 days27 (14.8)3 (20.0)24 (14.4)
    >30 days30 (16.5)2 (13.3)28 (16.8)
    At hospital death
    Yes29 (15.9)8 (53.3)21 (12.6).001*
    No146 (80.2)7 (46.7)139 (83.2)
    Unknown7 (3.8)0 (0.0)7 (4.2)
    Other factors Mean±SD p-value #
    NIHSS score in ER10.3±7.017.0±6.49.7±6.7.001*
    ECHO – Ejection fraction55.3±10.751.6±15.055.5±10.3.322
    Hemoglobin13.9±9.611.8±2.414.1±9.9.360
    Highest WBCs count 1st 48 hours9.9±4.611.1±4.99.8±4.5.279
    HbA1c7.1±2.16.7±2.17.2±2.1.620
    Highest glucose level220.1±152.3305.3±155.7214.7±151.1.049*
    LDL102.5±49.7111.4±54.1101.9±49.7.652
    • P- Exact probability test,

    • ↵# - independent t-test

    • ↵* p<0.05 (significant),

    • ICH - intracerebral hemorrhage, TIA - transient ischemic attack, NIHSS - National Institutes of Health Stroke Scale, WBC - White Blood Cells, LDL - low-density lipoprotein

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Incidence and risk factors of contrast-induced nephropathy in acute stroke patients undergoing computed tomography angiography: A single-center study
Muhannad A. Asiri, Mohammed S. Alqahtani, Saeed A. Alqahtani, Mohammed M. Alwadai, Naif F. Alharbi, Mohammed O. Aqeeli, Saeed S. Alzahrani
Neurosciences Journal Oct 2023, 28 (4) 258-263; DOI: 10.17712/nsj.2023.4.20230030

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Incidence and risk factors of contrast-induced nephropathy in acute stroke patients undergoing computed tomography angiography: A single-center study
Muhannad A. Asiri, Mohammed S. Alqahtani, Saeed A. Alqahtani, Mohammed M. Alwadai, Naif F. Alharbi, Mohammed O. Aqeeli, Saeed S. Alzahrani
Neurosciences Journal Oct 2023, 28 (4) 258-263; DOI: 10.17712/nsj.2023.4.20230030
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