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. 2018 Jan;59(1):107-112.
doi: 10.3349/ymj.2018.59.1.107.

Contrast-Induced Acute Kidney Injury after Coil Embolization for Aneurysmal Subarachnoid Hemorrhage

Hyun Goo Lee #  1 , Won Ki Kim #  2 , Je Young Yeon  1 , Jong Soo Kim  1 , Keon Ha Kim  3 , Pyoung Jeon  3 , Seung Chyul Hong  4
Affiliations

Contrast-Induced Acute Kidney Injury after Coil Embolization for Aneurysmal Subarachnoid Hemorrhage

Hyun Goo Lee et al. Yonsei Med J. 2018 Jan.

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.

Keywords: Subarachnoid hemorrhage; coil embolization; contrast induced acute kidney injury; contrast induced nephropathy; outcome; prognosis.

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Conflict of interest statement

The authors have no financial conflicts of interest.

Figures

Fig. 1
Fig. 1. Mortality and functional outcomes (modified Rankin Scale ≥3) in one-year after coil embolization in patients with aneurysmal subarachnoid hemorrhage. CI-AKI, contrast-induced acute kidney injury.
See this image and copyright information in PMC

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