Abstract T P29: The Impact of Contrast Based CTA/CTP Brain Attack Protocol on Kidney Function
Background: We aimed to evaluate the occurrence of acute kidney injury (AKI) associated with contrast based CTA/CTP Brain Attack (BAT) Protocol in a cohort of patients who presented to an academic stroke center with acute stroke symptoms.
Methods: Consecutive patients who presented to the Emergency Department with acute stroke symptoms from 01/12 to 12/12 and received CTA/CTP contrast-based BAT protocol were identified and their medical records reviewed. Clinicodemographic information was retrieved. Serum creatinine values at baseline, at discharge, and at a follow-up visit, as well as the highest in-hospital value were recorded. AKI was defined as a 0.3 absolute increase in creatinine level from baseline. A logistic regression was fit to identify the potential predictors for AKI.
Results: Of 348 patients had complete information. 37(11%) patients experienced AKI during hospitalization. Of 38 patients, 16 (43%) patients had persistent elevated creatinine at hospital discharge (5 patients also received endovascular therapy); 11(38%) patients returned to baseline, and the rest 10(26%) patients’ creatinine improved but did not return to baseline. No patient develops end stage renal disease requiring hemodialysis. Baseline creatinine level (p<0.002), comorbidity index (p=0.05) and endovascular therapy (p=0.01) were the three main predictors of AKI. Race, gender and age were not predictors of AKI.
Conclusion: Contrast based CTA/CTP BAT protocol may incur a small risk of AKI in patients but clinical consequences are minimal. Risks seem greater in patients with higher presenting creatinine level, more comorbidities and those receiving additional contrast from endovascular therapy. More data are required to understand the clinical impact of contrast-based CT stroke imaging protocols.
Author Disclosures: J. Folsom: None. N. Ezerioha: None. P. Chhatbar: None. S. Pawar: None. C. Holmstedt: None. E. Jauch: Research Grant; Modest; Ischemia Care. B. Ovbiagele: Research Grant; Significant; NIH. R.J. Adams: Research Grant; Significant; NIH, DOD. W. Feng: Research Grant; Significant; American Heart Association Scientist Development Grant, National Institute of Health, Halo Neuroscience Inc..
- © 2015 by American Heart Association, Inc.