Research Article
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Year 2023, Volume: 5 Issue: 4, 271 - 281, 29.10.2023

Hamide Ayben Korkmaz Rıfat Akdağ İlkay Ceylan

https://doi.org/10.46310/tjim.1358676

Abstract

References

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Contrast-Induced Acute Kidney Injury in Patients Followed at the Intensive Care Unit after Aneurysmal Subarachnoid Haemorrhage (Fisher Grade IV) Surgery:A Retrospective Study

Year 2023, Volume: 5 Issue: 4, 271 - 281, 29.10.2023

Hamide Ayben Korkmaz Rıfat Akdağ İlkay Ceylan

https://doi.org/10.46310/tjim.1358676

Abstract

Background: Contrast-enhanced imaging studies are widely used to diagnose and follow up acute cerebrovascular diseases. Exposure to contrast media may lead to nephropathy. This study investigated the incidence of contrast-induced acute kidney injury during intensive care follow-up of patients who underwent aneurysmal subarachnoid haemorrhage surgery and the impact of this condition on patient outcomes.
Material and Methods: Patients >18 years of age with no known renal injury and admitted to the intensive care unit after Fisher Grade IV aneurysmal subarachnoid haemorrhage and surgery between January 2017 and June 2022 were retrospectively analysed. Renal injury was defined as a renal injury occurring within 48 hours of exposure to contrast media in line with the Kidney Disease Improving Global Outcomes criteria.
Results: Among the 85 patients with subarachnoid haemorrhage who received at least one contrast medium, the mean age was 55, and 40% were female. 11.8% of the patients were found to have early acute kidney injury and were non-oliguric. At 48 hours, six, three, and one patients had Stage 1, 2, and 3 injuries, respectively. None of the patients required renal replacement therapy. Patients received a mean of 2 mL/kg/h saline infusion after contrast media administration and had a mean arterial pressure of 93.6 mmHg. There was no association between acute kidney injury and comorbidities, Glasgow coma scale, or APACHE II scores.
Conclusions: The study found that the incidence of contrast-induced acute kidney injury was low and transient in patients followed at the ICU after aneurysmal subarachnoid haemorrhage (Fisher Grade IV) surgery. Adequate hydration and hemodynamic stability were found to be effective in reducing acute kidney injury in these patients.

Keywords

Subarachnoid haemorrhage intensive care unit acute kidney injury contrast media KDIGO

References

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  • Eagles ME, Powell MF, Ayling OGS, Tso MK, Macdonald RL. Acute kidney injury after aneurysmal subarachnoid hemorrhage and its effect on patient outcome: an exploratory analysis. J Neurosurg. 2019 Jul 12:1-8. doi: 10.3171/2019.4.JNS19103.
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  • McDonald JS, Leake CB, McDonald RJ, Gulati R, Katzberg RW, Williamson EE, Kallmes DF. Acute kidney injury after intravenous versus intra-arterial contrast material administration in a paired cohort. Invest Radiol. 2016 Dec;51(12):804-9. doi: 10.1097/RLI.0000000000000298.
  • Clec'h C, Razafimandimby D, Laouisset M, Chemouni F, Cohen Y. Incidence and outcome of contrast-associated acute kidney injury in a mixed medical-surgical ICU population: a retrospective study. BMC Nephrol. 2013 Feb 4;14:31. doi: 10.1186/1471-2369-14-31.
  • Feigin VL, Rinkel GJ, Lawes CM, Algra A, Bennett DA, van Gijn J, Anderson CS. Risk factors for subarachnoid hemorrhage: an updated systematic review of epidemiological studies. Stroke. 2005 Dec;36(12):2773-80. doi: 10.1161/01.STR.0000190838.02954.e8.
  • Connolly ES Jr, Rabinstein AA, Carhuapoma JR, Derdeyn CP, Dion J, Higashida RT, Hoh BL, Kirkness CJ, Naidech AM, Ogilvy CS, Patel AB, Thompson BG, Vespa P; American Heart Association Stroke Council; Council on Cardiovascular Radiology and Intervention; Council on Cardiovascular Nursing; Council on Cardiovascular Surgery and Anesthesia; Council on Clinical Cardiology. Guidelines for the management of aneurysmal subarachnoid hemorrhage: a guideline for healthcare professionals from the American Heart Association/american Stroke Association. Stroke. 2012 Jun;43(6):1711-37. doi: 10.1161/STR.0b013e3182587839.
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  • Rao QA, Newhouse JH. Risk of nephropathy after intravenous administration of contrast material: a critical literature analysis. Radiology. 2006 May;239(2):392-7. doi: 10.1148/radiol.2392050413.
  • Kellum JA, Bellomo R, Ronco C. Definition and classification of acute kidney injury. Nephron Clin Pract. 2008;109(4):c182-7. doi: 10.1159/000142926.
  • Zhang P, Guan C, Li C, Zhu Z, Zhang W, Luan H, Zhou B, Man X, Che L, Wang Y, Zhao L, Zhang H, Luo C, Xu Y. A visual risk assessment tool for acute kidney injury after intracranial aneurysm clipping surgery. Ren Fail. 2020 Nov;42(1):1093-9. doi: 10.1080/0886022X.2020.1838299.
  • McDonald JS, McDonald RJ, Carter RE, Katzberg RW, Kallmes DF, Williamson EE. Risk of intravenous contrast material-mediated acute kidney injury: a propensity score-matched study stratified by baseline-estimated glomerular filtration rate. Radiology. 2014 Apr;271(1):65-73. doi: 10.1148/radiol.13130775.
  • Davenport MS, Khalatbari S, Cohan RH, Dillman JR, Myles JD, Ellis JH. Contrast material-induced nephrotoxicity and intravenous low-osmolality iodinated contrast material: risk stratification by using estimated glomerular filtration rate. Radiology. 2013 Sep;268(3):719-28. doi: 10.1148/radiol.13122276.
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  • Er F, Nia AM, Dopp H, Dahlem KM, Caglayan E, Erdmann E, Gassanov N, Hellmich M, Burst V, Kubacki T, Benzing T. Response to letter regarding article, "Ischemic preconditioning for prevention of contrast medium-induced nephropathy: randomized Pilot RenPro-Trial (Renal Protection Trial)". Circulation. 2013 Apr 2;127(13):e536. doi: 10.1161/circulationaha.112.147587.
  • Mueller C. Prevention of contrast-induced nephropathy with volume supplementation. Kidney Int Suppl. 2006 Apr;(100):S16-9. doi: 10.1038/sj.ki.5000369.
  • Schönenberger E, Martus P, Bosserdt M, Zimmermann E, Tauber R, Laule M, Dewey M. Kidney injury after intravenous versus intra-arterial contrast agent in patients suspected of having coronary artery disease: A randomized trial. Radiology. 2019 Sep;292(3):664-72. doi: 10.1148/radiol.2019182220.
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There are 53 citations in total.

Details

Primary Language English
Subjects Intensive Care
Journal Section Original Articles
Authors

Hamide Ayben Korkmaz 0000-0002-2845-0586

Rıfat Akdağ 0000-0001-7638-8361

İlkay Ceylan 0000-0003-3306-3107

Publication Date October 29, 2023
Submission Date September 11, 2023
Acceptance Date October 23, 2023
Published in Issue Year 2023 Volume: 5 Issue: 4

Cite

EndNote Korkmaz HA, Akdağ R, Ceylan İ (October 1, 2023) Contrast-Induced Acute Kidney Injury in Patients Followed at the Intensive Care Unit after Aneurysmal Subarachnoid Haemorrhage (Fisher Grade IV) Surgery:A Retrospective Study. Turkish Journal of Internal Medicine 5 4 271–281.
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