Contrast-Induced Nephropathy in Ischemic Stroke Patients Undergoing Computed Tomography Angiography

CINISter Study

Anthony Rowe, Brandon Hawkins, Leslie Hamilton, Andrew Ferrell, Jennifer Henry, Brian Wiseman, Steven A. Skovran, Mitra S. Mosadegh, Marion Hare, Mehmet Kocak, Elizabeth Tolley

Research output: Contribution to journalArticle

Abstract

Goal: Computed tomography angiography (CTA) is a well-tolerated, noninvasive study of the intracranial vascular circulation; however, contrast-induced nephropathy (CIN) has been reported in 5%-7% of patients undergoing CTA. Limited studies have evaluated the risks of CIN in patients undergoing CTA. Our study was designed to evaluate the prevalence and risk factors for CIN in patients with ischemic stroke who receive a CTA. Materials and Methods: Single-center, nested, case-control study of patients with ischemic stroke who received a CTA between June 18, 2012 and January 1, 2016. Patients were grouped based on development of CIN. Findings: A total of 209 patients were included in the final analysis (178 controls, 31 cases). The prevalence of CIN during the time period studied was 14.8% (95% confidence interval [CI]: 10.2-20.2). A higher proportion of patients who developed CIN had a history of diabetes mellitus (37 [20.56%] versus 15 [48.39%]; P =.0009) and reported taking no medications prior to admission (35 [19.44%] versus 11 [35.48%]; P =.0458). However, a lower proportion of patients who developed CIN had a history of smoking (59 [32.78] versus 3 [9.68]; P =.0091). After statistical adjustment, only a history of diabetes (odds ratio [OR] 4.15 [95% CI: 1.765, 9.754), taking no medications prior to admission (OR 3.56 [95% CI: 1.417, 8.941]) and a self-reported history of smoking (OR 0.204 [95% CI: 0.057, 0.721]) remained associated with the development of CIN. Conclusions: Those patients with a history of diabetes mellitus or not taking medications prior to admission should be monitored closely for the development of contrast-induced nephropathy CIN.

Original languageEnglish (US)
Pages (from-to)649-654
Number of pages6
JournalJournal of Stroke and Cerebrovascular Diseases
Volume28
Issue number3
DOIs
StatePublished - Mar 1 2019

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Stroke
Confidence Intervals
Odds Ratio
Diabetes Mellitus
Smoking
Social Adjustment
Computed Tomography Angiography
Blood Vessels
Case-Control Studies

All Science Journal Classification (ASJC) codes

  • Surgery
  • Rehabilitation
  • Clinical Neurology
  • Cardiology and Cardiovascular Medicine

Cite this

@article{67d8977cee73409996081056e59090a9,
title = "Contrast-Induced Nephropathy in Ischemic Stroke Patients Undergoing Computed Tomography Angiography: CINISter Study",
abstract = "Goal: Computed tomography angiography (CTA) is a well-tolerated, noninvasive study of the intracranial vascular circulation; however, contrast-induced nephropathy (CIN) has been reported in 5{\%}-7{\%} of patients undergoing CTA. Limited studies have evaluated the risks of CIN in patients undergoing CTA. Our study was designed to evaluate the prevalence and risk factors for CIN in patients with ischemic stroke who receive a CTA. Materials and Methods: Single-center, nested, case-control study of patients with ischemic stroke who received a CTA between June 18, 2012 and January 1, 2016. Patients were grouped based on development of CIN. Findings: A total of 209 patients were included in the final analysis (178 controls, 31 cases). The prevalence of CIN during the time period studied was 14.8{\%} (95{\%} confidence interval [CI]: 10.2-20.2). A higher proportion of patients who developed CIN had a history of diabetes mellitus (37 [20.56{\%}] versus 15 [48.39{\%}]; P =.0009) and reported taking no medications prior to admission (35 [19.44{\%}] versus 11 [35.48{\%}]; P =.0458). However, a lower proportion of patients who developed CIN had a history of smoking (59 [32.78] versus 3 [9.68]; P =.0091). After statistical adjustment, only a history of diabetes (odds ratio [OR] 4.15 [95{\%} CI: 1.765, 9.754), taking no medications prior to admission (OR 3.56 [95{\%} CI: 1.417, 8.941]) and a self-reported history of smoking (OR 0.204 [95{\%} CI: 0.057, 0.721]) remained associated with the development of CIN. Conclusions: Those patients with a history of diabetes mellitus or not taking medications prior to admission should be monitored closely for the development of contrast-induced nephropathy CIN.",
author = "Anthony Rowe and Brandon Hawkins and Leslie Hamilton and Andrew Ferrell and Jennifer Henry and Brian Wiseman and Skovran, {Steven A.} and Mosadegh, {Mitra S.} and Marion Hare and Mehmet Kocak and Elizabeth Tolley",
year = "2019",
month = "3",
day = "1",
doi = "10.1016/j.jstrokecerebrovasdis.2018.11.012",
language = "English (US)",
volume = "28",
pages = "649--654",
journal = "Journal of Stroke and Cerebrovascular Diseases",
issn = "1052-3057",
publisher = "W.B. Saunders Ltd",
number = "3",

}

TY - JOUR

T1 - Contrast-Induced Nephropathy in Ischemic Stroke Patients Undergoing Computed Tomography Angiography

T2 - CINISter Study

AU - Rowe, Anthony

AU - Hawkins, Brandon

AU - Hamilton, Leslie

AU - Ferrell, Andrew

AU - Henry, Jennifer

AU - Wiseman, Brian

AU - Skovran, Steven A.

AU - Mosadegh, Mitra S.

AU - Hare, Marion

AU - Kocak, Mehmet

AU - Tolley, Elizabeth

PY - 2019/3/1

Y1 - 2019/3/1

N2 - Goal: Computed tomography angiography (CTA) is a well-tolerated, noninvasive study of the intracranial vascular circulation; however, contrast-induced nephropathy (CIN) has been reported in 5%-7% of patients undergoing CTA. Limited studies have evaluated the risks of CIN in patients undergoing CTA. Our study was designed to evaluate the prevalence and risk factors for CIN in patients with ischemic stroke who receive a CTA. Materials and Methods: Single-center, nested, case-control study of patients with ischemic stroke who received a CTA between June 18, 2012 and January 1, 2016. Patients were grouped based on development of CIN. Findings: A total of 209 patients were included in the final analysis (178 controls, 31 cases). The prevalence of CIN during the time period studied was 14.8% (95% confidence interval [CI]: 10.2-20.2). A higher proportion of patients who developed CIN had a history of diabetes mellitus (37 [20.56%] versus 15 [48.39%]; P =.0009) and reported taking no medications prior to admission (35 [19.44%] versus 11 [35.48%]; P =.0458). However, a lower proportion of patients who developed CIN had a history of smoking (59 [32.78] versus 3 [9.68]; P =.0091). After statistical adjustment, only a history of diabetes (odds ratio [OR] 4.15 [95% CI: 1.765, 9.754), taking no medications prior to admission (OR 3.56 [95% CI: 1.417, 8.941]) and a self-reported history of smoking (OR 0.204 [95% CI: 0.057, 0.721]) remained associated with the development of CIN. Conclusions: Those patients with a history of diabetes mellitus or not taking medications prior to admission should be monitored closely for the development of contrast-induced nephropathy CIN.

AB - Goal: Computed tomography angiography (CTA) is a well-tolerated, noninvasive study of the intracranial vascular circulation; however, contrast-induced nephropathy (CIN) has been reported in 5%-7% of patients undergoing CTA. Limited studies have evaluated the risks of CIN in patients undergoing CTA. Our study was designed to evaluate the prevalence and risk factors for CIN in patients with ischemic stroke who receive a CTA. Materials and Methods: Single-center, nested, case-control study of patients with ischemic stroke who received a CTA between June 18, 2012 and January 1, 2016. Patients were grouped based on development of CIN. Findings: A total of 209 patients were included in the final analysis (178 controls, 31 cases). The prevalence of CIN during the time period studied was 14.8% (95% confidence interval [CI]: 10.2-20.2). A higher proportion of patients who developed CIN had a history of diabetes mellitus (37 [20.56%] versus 15 [48.39%]; P =.0009) and reported taking no medications prior to admission (35 [19.44%] versus 11 [35.48%]; P =.0458). However, a lower proportion of patients who developed CIN had a history of smoking (59 [32.78] versus 3 [9.68]; P =.0091). After statistical adjustment, only a history of diabetes (odds ratio [OR] 4.15 [95% CI: 1.765, 9.754), taking no medications prior to admission (OR 3.56 [95% CI: 1.417, 8.941]) and a self-reported history of smoking (OR 0.204 [95% CI: 0.057, 0.721]) remained associated with the development of CIN. Conclusions: Those patients with a history of diabetes mellitus or not taking medications prior to admission should be monitored closely for the development of contrast-induced nephropathy CIN.

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U2 - 10.1016/j.jstrokecerebrovasdis.2018.11.012

DO - 10.1016/j.jstrokecerebrovasdis.2018.11.012

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