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

• Published in: Yonsei medical journal Vol. 59; no. 1; pp. 107 - 112
• Main Authors: Lee, Hyun Goo, Kim, Won ki, Yeon, Je Young, Kim, Jong Soo, Kim, Keon Ha, Jeon, Pyoung, Hong, Seung Chyul
• Format: Journal Article
• Language: English
• Published: Korea (South) Yonsei University College of Medicine 01.01.2018; 연세대학교의과대학
• Subjects: Original; 의학일반; Subarachnoid hemorrhage; prognosis; contrast induced nephropathy; outcome; coil embolization; contrast induced acute kidney injury
• ISSN: 0513-5796; 1976-2437; 1976-2437
• DOI: 10.3349/ymj.2018.59.1.107

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). 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. 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. CI-AKI seems to be an independent predictor of the overall outcomes of aSAH after endovascular treatment.