Journals / Turkish Journal of Internal Medicine / 2023 / Cilt: 5 Sayı: 4

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

Pages
271–281
Publication Date
2023-10-29
DOI
—
🏛️Bibliographic metadata and full text access for this article are provided via DergiPark.
DergiPark Record ↗
✨

AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

Adequate hydration and hemodynamic stability were found to be effective in reducing acute kidney injury in these patients.

📌 3 Key Takeaways

🎯
Objective & Hypothesis:Background: Contrast-enhanced imaging studies are widely used to diagnose and follow up acute cerebrovascular diseases.
📊
Key Findings & Data: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.
💡
Conclusion & Impact:Adequate hydration and hemodynamic stability were found to be effective in reducing acute kidney injury in these patients.
🔬Design:Research Article
📍Scope:2017 Verileri
⚙️Variables:Subarachnoid haemorrhage · intensive care unit · acute kidney injury

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.

🔖

Cite This Article

KORKMAZ, H. A., AKDAĞ, R., CEYLAN, İ. (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, Cilt: 5 Sayı: 4, 271–281. https://ajindex.com/articles/970012

📄 Full Text PDF Viewer

📄

PDF görüntüleyici hazırlanıyor...

References (3)

  1. Nieuwkamp DJ, Setz LE, Algra A, Linn FH, de Rooij NK, Rinkel GJ. Changes in case fatality of aneurysmal subarachnoid haemorrhage over time, according to age, sex, and region: A meta-analysis. Lancet Neurol. 2009 Jul;8(7):635-42. doi: 10.1016/S1474-4422(09)70126-7.
  2. Espiner EA, Leikis R, Ferch RD, MacFarlane MR, Bonkowski JA, Frampton CM, Richards AM. The neuro-cardio-endocrine response to acute subarachnoid haemorrhage. Clin Endocrinol (Oxf). 2002 May;56(5):629-35. doi: 10.1046/j.1365-2265.2002.01285.x. 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. ACR Manual on contrast media v10.2 [Internet]. Reston (VA): American College of Radiology; 2016. Available at: http://www.acr.org/quality-safety/resources/contrast-manual.
  3. Lee HG, Kim WK, Yeon JY, Kim JS, Kim KH, Jeon P, Hong SC. Contrast-induced acute kidney ınjury after coil embolization for aneurysmal subarachnoid hemorrhage. Yonsei Med J. 2018 Jan;59(1):107-12. doi: 10.3349/ymj.2018.59.1.107. Nash K, Hafeez A, Hou S. Hospital-acquired renal insufficiency. Am J Kidney Dis. 2002 May;39(5):930-6. doi: 10.1053/ajkd.2002.32766. Waikar S, Liu K, Chertow G. Diagnosis, epidemiology and outcomes of acute kidney injury. Clin J Am Soc Nephrol. 2008 May;3(3):844-61. doi: 10.2215/CJN.05191107. Barrett BJ, Parfrey PS. Clinical practice. Preventing nephropathy induced by contrast medium. N Engl J Med. 2006 Jan 26;354(4):379-86. doi: 10.1056/NEJMcp050801. Geenen RWF, Kingma HJ, van der Molen AJ. Pathophysiology of contrast-induced acute kidney injury. Interv Cardiol Clin. 2014 Jul;3(3):363-7. doi: 10.1016/j.iccl.2014.03.007. E Goldfarb S, McCullough PA, McDermott J, Gay SB. Contrast-induced acute kidney injury: specialty-specific protocols for interventional radiology, diagnostic computed tomography radiology, and interventional cardiology. Mayo Clin Proc. 2009 Feb;84(2):170-9. doi: 10.4065/84.2.170. Kellum JA, Lameire N, Aspelin P, Barsoum RS, Burdmann EA, Goldstein SL, Herzog CA, Joannidis M, Kribben A, Levey AS, MacLeod AM, Mehta RL, Murray PT, Naicker S, Opal SM, Schaefer F, Schetz M, Uchino S. Kidney disease: Improving global outcomes (KDIGO) acute kidney injury work group. KDIGO clinical practice guideline for acute kidney injury. Kidney Int Suppl. 2012;2(1):1-138. doi: 10.1038/kisup.2012.1. Claassen J, Bernardini GL, Kreiter K, Ba