Contrast-Induced Acute Kidney Injury after Coil Embolization for Aneurysmal Subarachnoid Hemorrhage
10.3349/ymj.2018.59.1.107
- Author:
Hyun Goo LEE
1
;
Won Ki KIM
;
Je Young YEON
;
Jong Soo KIM
;
Keon Ha KIM
;
Pyoung JEON
;
Seung Chyul HONG
Author Information
1. Department of Neurosurgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. nsschong@skku.edu
- Publication Type:Original Article
- Keywords:
Subarachnoid hemorrhage;
coil embolization;
outcome;
contrast induced acute kidney injury;
contrast induced nephropathy;
prognosis
- MeSH:
Acute Kidney Injury/chemically induced;
Acute Kidney Injury/diagnostic imaging;
Acute Kidney Injury/etiology;
Acute Kidney Injury/mortality;
Adult;
Aged;
Aged, 80 and over;
Aneurysm/complications;
Aneurysm/diagnostic imaging;
Aneurysm/therapy;
Angiography;
Contrast Media/adverse effects;
Embolization, Therapeutic/adverse effects;
Female;
Humans;
Incidence;
Male;
Middle Aged;
Subarachnoid Hemorrhage/complications;
Subarachnoid Hemorrhage/diagnostic imaging;
Subarachnoid Hemorrhage/therapy;
Treatment Outcome;
Young Adult
- From:Yonsei Medical Journal
2018;59(1):107-112
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: Contrast-induced acute kidney injury (CI-AKI) is associated with poor outcomes after percutaneous coronary intervention. However, CI-AKI has rarely been evaluated within the neurovascular field. The aim of this study was to investigate the incidence and clinical implication of CI-AKI after coil embolization in patients with an aneurysmal subarachnoid hemorrhage (aSAH). MATERIALS AND METHODS: Between January 2005 and March 2016, 192 patients who underwent coil embolization were enrolled in this study. CI-AKI was defined as an increase from baseline serum creatinine concentration of >25% or >0.5 mg/dL within 72 hours after coil embolization. A poor clinical outcome was defined as a score of ≥3 on the modified Rankin Scale at one-year post-treatment. RESULTS: A total of 16 patients (8.3%) died as a result of medical problems within one year. CI-AKI was identified in 14 patients (7.3%). Prominent risk factors for one-year mortality included CI-AKI [odds ratio (OR): 16.856; 95% confidence interval (CI): 3.437–82.664] and an initial Glasgow Coma Scale (GCS) score ≤8 (OR: 5.565; 95% CI: 1.703–18.184). A poor clinical outcome was associated with old age (≥65 years) (OR: 7.921; 95% CI: 2.977–21.076), CI-AKI (OR: 11.281; 95% CI: 2.138–59.525), an initial GCS score ≤8 (OR 31.02; 95% CI, 10.669–90.187), and a ruptured aneurysm (p=0.016, OR: 4.278) in posterior circulation. CONCLUSION: CI-AKI seems to be an independent predictor of the overall outcomes of aSAH after endovascular treatment.
