Association between Acute Kidney Disease and Intravenous Dye Administration in Patients with Acute Stroke: A Population-Based Study

Stacie L. Demel, Aaron W. Grossman, Jane C. Khoury, Charles J. Moomaw, Kathleen Alwell, Brett M. Kissela, Daniel Woo, Matthew L. Flaherty, Simona Ferioli, Jason Mackey, Felipe De Los Rios La Rosa, Sharyl Martini, Opeolu Adeoye, Dawn O. Kleindorfer

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

Background and Purpose-Computed tomographic angiography and conventional angiography provide timely vascular anatomic information in patients with stroke. However, iodinated contrast dye may cause acute kidney injury (AKI). Within a large, biracial population, we examined in-hospital incidence of new or worsening kidney disease in patients with stroke and its association with administration of intravenous dye. Methods-All adult residents of the Greater Cincinnati/Northern Kentucky region with acute ischemic stroke or intracerebral hemorrhage who presented to an emergency department in 2010 were included. Prevalence of unsuspected kidney disease at the time of emergency department presentation and the incidence of AKI after admission in 2 groups of patients-those who did and those who did not receive intravenous dye-were determined. Results-In 2010, 2299 patients met inclusion criteria (89% ischemic stroke and 11% intracerebral hemorrhage); mean age 69 years (SD 15), 22% black, and 54% women. Among these patients, 37% had kidney disease at baseline, including 22% (516/2299) in whom this was unsuspected. Two percent (2%; 15/853) of patients with baseline kidney disease developed AKI during the hospital stay. Of those with no baseline kidney disease, 1% (14/14 467) developed AKI. There was no association between dye administration and new or worsening kidney disease. Conclusions-Although 22% of patients in the Greater Cincinnati/Northern Kentucky stroke population had unsuspected kidney disease, the incidence of new or worsening kidney disease was low, and AKI was not associated with dye administration. These findings confirm single-center reports that the risk of severe renal complications after contrast dye is small.

Original languageEnglish (US)
Pages (from-to)835-839
Number of pages5
JournalStroke
Volume48
Issue number4
DOIs
StatePublished - Apr 1 2017

Fingerprint

Kidney Diseases
Acute Disease
Intravenous Administration
Coloring Agents
Stroke
Acute Kidney Injury
Population
Cerebral Hemorrhage
Hospital Emergency Service
Incidence
Angiography
Blood Vessels
Length of Stay
Kidney

Keywords

  • acute kidney injury
  • contrast media
  • diagnostic imaging
  • epidemiology
  • stroke

ASJC Scopus subject areas

  • Clinical Neurology
  • Cardiology and Cardiovascular Medicine
  • Advanced and Specialized Nursing

Cite this

Demel, S. L., Grossman, A. W., Khoury, J. C., Moomaw, C. J., Alwell, K., Kissela, B. M., ... Kleindorfer, D. O. (2017). Association between Acute Kidney Disease and Intravenous Dye Administration in Patients with Acute Stroke: A Population-Based Study. Stroke, 48(4), 835-839. https://doi.org/10.1161/STROKEAHA.116.014603

Association between Acute Kidney Disease and Intravenous Dye Administration in Patients with Acute Stroke : A Population-Based Study. / Demel, Stacie L.; Grossman, Aaron W.; Khoury, Jane C.; Moomaw, Charles J.; Alwell, Kathleen; Kissela, Brett M.; Woo, Daniel; Flaherty, Matthew L.; Ferioli, Simona; Mackey, Jason; De Los Rios La Rosa, Felipe; Martini, Sharyl; Adeoye, Opeolu; Kleindorfer, Dawn O.

In: Stroke, Vol. 48, No. 4, 01.04.2017, p. 835-839.

Research output: Contribution to journalArticle

Demel, SL, Grossman, AW, Khoury, JC, Moomaw, CJ, Alwell, K, Kissela, BM, Woo, D, Flaherty, ML, Ferioli, S, Mackey, J, De Los Rios La Rosa, F, Martini, S, Adeoye, O & Kleindorfer, DO 2017, 'Association between Acute Kidney Disease and Intravenous Dye Administration in Patients with Acute Stroke: A Population-Based Study', Stroke, vol. 48, no. 4, pp. 835-839. https://doi.org/10.1161/STROKEAHA.116.014603
Demel, Stacie L. ; Grossman, Aaron W. ; Khoury, Jane C. ; Moomaw, Charles J. ; Alwell, Kathleen ; Kissela, Brett M. ; Woo, Daniel ; Flaherty, Matthew L. ; Ferioli, Simona ; Mackey, Jason ; De Los Rios La Rosa, Felipe ; Martini, Sharyl ; Adeoye, Opeolu ; Kleindorfer, Dawn O. / Association between Acute Kidney Disease and Intravenous Dye Administration in Patients with Acute Stroke : A Population-Based Study. In: Stroke. 2017 ; Vol. 48, No. 4. pp. 835-839.
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abstract = "Background and Purpose-Computed tomographic angiography and conventional angiography provide timely vascular anatomic information in patients with stroke. However, iodinated contrast dye may cause acute kidney injury (AKI). Within a large, biracial population, we examined in-hospital incidence of new or worsening kidney disease in patients with stroke and its association with administration of intravenous dye. Methods-All adult residents of the Greater Cincinnati/Northern Kentucky region with acute ischemic stroke or intracerebral hemorrhage who presented to an emergency department in 2010 were included. Prevalence of unsuspected kidney disease at the time of emergency department presentation and the incidence of AKI after admission in 2 groups of patients-those who did and those who did not receive intravenous dye-were determined. Results-In 2010, 2299 patients met inclusion criteria (89{\%} ischemic stroke and 11{\%} intracerebral hemorrhage); mean age 69 years (SD 15), 22{\%} black, and 54{\%} women. Among these patients, 37{\%} had kidney disease at baseline, including 22{\%} (516/2299) in whom this was unsuspected. Two percent (2{\%}; 15/853) of patients with baseline kidney disease developed AKI during the hospital stay. Of those with no baseline kidney disease, 1{\%} (14/14 467) developed AKI. There was no association between dye administration and new or worsening kidney disease. Conclusions-Although 22{\%} of patients in the Greater Cincinnati/Northern Kentucky stroke population had unsuspected kidney disease, the incidence of new or worsening kidney disease was low, and AKI was not associated with dye administration. These findings confirm single-center reports that the risk of severe renal complications after contrast dye is small.",
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AU - Demel, Stacie L.

AU - Grossman, Aaron W.

AU - Khoury, Jane C.

AU - Moomaw, Charles J.

AU - Alwell, Kathleen

AU - Kissela, Brett M.

AU - Woo, Daniel

AU - Flaherty, Matthew L.

AU - Ferioli, Simona

AU - Mackey, Jason

AU - De Los Rios La Rosa, Felipe

AU - Martini, Sharyl

AU - Adeoye, Opeolu

AU - Kleindorfer, Dawn O.

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N2 - Background and Purpose-Computed tomographic angiography and conventional angiography provide timely vascular anatomic information in patients with stroke. However, iodinated contrast dye may cause acute kidney injury (AKI). Within a large, biracial population, we examined in-hospital incidence of new or worsening kidney disease in patients with stroke and its association with administration of intravenous dye. Methods-All adult residents of the Greater Cincinnati/Northern Kentucky region with acute ischemic stroke or intracerebral hemorrhage who presented to an emergency department in 2010 were included. Prevalence of unsuspected kidney disease at the time of emergency department presentation and the incidence of AKI after admission in 2 groups of patients-those who did and those who did not receive intravenous dye-were determined. Results-In 2010, 2299 patients met inclusion criteria (89% ischemic stroke and 11% intracerebral hemorrhage); mean age 69 years (SD 15), 22% black, and 54% women. Among these patients, 37% had kidney disease at baseline, including 22% (516/2299) in whom this was unsuspected. Two percent (2%; 15/853) of patients with baseline kidney disease developed AKI during the hospital stay. Of those with no baseline kidney disease, 1% (14/14 467) developed AKI. There was no association between dye administration and new or worsening kidney disease. Conclusions-Although 22% of patients in the Greater Cincinnati/Northern Kentucky stroke population had unsuspected kidney disease, the incidence of new or worsening kidney disease was low, and AKI was not associated with dye administration. These findings confirm single-center reports that the risk of severe renal complications after contrast dye is small.

AB - Background and Purpose-Computed tomographic angiography and conventional angiography provide timely vascular anatomic information in patients with stroke. However, iodinated contrast dye may cause acute kidney injury (AKI). Within a large, biracial population, we examined in-hospital incidence of new or worsening kidney disease in patients with stroke and its association with administration of intravenous dye. Methods-All adult residents of the Greater Cincinnati/Northern Kentucky region with acute ischemic stroke or intracerebral hemorrhage who presented to an emergency department in 2010 were included. Prevalence of unsuspected kidney disease at the time of emergency department presentation and the incidence of AKI after admission in 2 groups of patients-those who did and those who did not receive intravenous dye-were determined. Results-In 2010, 2299 patients met inclusion criteria (89% ischemic stroke and 11% intracerebral hemorrhage); mean age 69 years (SD 15), 22% black, and 54% women. Among these patients, 37% had kidney disease at baseline, including 22% (516/2299) in whom this was unsuspected. Two percent (2%; 15/853) of patients with baseline kidney disease developed AKI during the hospital stay. Of those with no baseline kidney disease, 1% (14/14 467) developed AKI. There was no association between dye administration and new or worsening kidney disease. Conclusions-Although 22% of patients in the Greater Cincinnati/Northern Kentucky stroke population had unsuspected kidney disease, the incidence of new or worsening kidney disease was low, and AKI was not associated with dye administration. These findings confirm single-center reports that the risk of severe renal complications after contrast dye is small.

KW - acute kidney injury

KW - contrast media

KW - diagnostic imaging

KW - epidemiology

KW - stroke

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