naa a22 4500 510799728 CHVBK 20180411083349.0 cr unu---uuuuu 180411e20131001xx s 000 0 eng 10.1007/s12028-013-9850-1 doi (NATIONALLICENCE)springer-10.1007/s12028-013-9850-1 Development of Contrast-Induced Nephropathy in Subarachnoid Hemorrhage: a Single Center Perspective [Elektronische Daten] [Bappaditya Ray, Kim Rickert, Babu Welch, Jonathan White, Daniel Klinger, Benjamin Boudreaux, Brett Whittemore, Eugene Gu] Background and Purpose: The use of iodinated contrast-enhanced imaging studies is increasing in acute cerebrovascular diseases, especially in subarachnoid hemorrhage (SAH). In SAH, such studies are essential for both diagnosis and treatment of the cause and sequela of hemorrhage. These patients are often subjected to multiple contrast studies such as computed tomographic angiography, computed tomographic perfusion, and cerebral angiography. They are also predisposed to intravascular volume depletion as a part of the disease process from cerebral salt wasting (CSW) and as a result of multiple contrast exposure can develop contrast-induced nephropathy (CIN). Data regarding CIN in this population are scarce. We aimed to examine the incidence of CIN in SAH and identify potential associative risk factors. Methods: We analyzed data from a prospectively collected patient database of patients with SAH admitted to the neurocritical intensive care unit in a single center over a period of 1year. CIN was defined as an increase in serum creatinine by>1.5 times or>0.3mg/dl greater than the admission value, or urine output<0.5ml/kg/h during one 6-h block. Results: In this cohort of 75 patients with SAH who had undergone at least one contrast study, the mean age was 57.3±15.6years and 70.7% were women. Four percent developed CIN which resolved within 72h and none required renal replacement therapy or dialysis. Patients older than 75years (20%, p<0.05), those with borderline renal function (14.3%, p=0.26), diabetics (11.1%, p=0.32), and those with lower recommended "maximum contrast dose” volume (33.3%, p=0.12) had a trend toward development of CIN, although most were not statistically significant. Twenty-seven patients (36%) were on 3% hypertonic saline (HTS) for CSW during the contrasted study but none developed CIN. Conclusions: The incidence of CIN in SAH patients is comparable to previously published reports on non-neurological cohorts. No definite association was noted with any predisposing factors postulated to be responsible for CIN, except for advanced age. Concurrent use of 3% HTS was not associated with CIN in this population. Springer Science+Business Media New York, 2013 Contrast-induced nephropathy nationallicence Subarachnoid hemorrhage nationallicence Acute kidney injury nationallicence Serum creatinine nationallicence Stroke nationallicence Hypertonic saline nationallicence Ray Bappaditya Division of Neurocritical Care, Department of Neurological Surgery and Neurology & Neurotherapeutics, University of Texas—Southwestern Medical Center, Dallas, TX, USA aut Rickert Kim Department of Neurological Surgery, University of Texas—Southwestern Medical Center, Dallas, TX, USA aut Welch Babu Department of Neurological Surgery, University of Texas—Southwestern Medical Center, Dallas, TX, USA aut White Jonathan Department of Neurological Surgery, University of Texas—Southwestern Medical Center, Dallas, TX, USA aut Klinger Daniel Department of Neurological Surgery, University of Texas—Southwestern Medical Center, Dallas, TX, USA aut Boudreaux Benjamin Department of Neurological Surgery, University of Texas—Southwestern Medical Center, Dallas, TX, USA aut Whittemore Brett Department of Neurological Surgery, University of Texas—Southwestern Medical Center, Dallas, TX, USA aut Gu Eugene Division of Neurocritical Care, Department of Neurological Surgery and Neurology & Neurotherapeutics, University of Texas—Southwestern Medical Center, Dallas, TX, USA aut Neurocritical Care Springer US; http://www.springer-ny.com 19/2(2013-10-01), 150-156 1541-6933 19:2<150 2013 19 12028 https://doi.org/10.1007/s12028-013-9850-1 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s12028-013-9850-1 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Ray Bappaditya Division of Neurocritical Care, Department of Neurological Surgery and Neurology & Neurotherapeutics, University of Texas—Southwestern Medical Center, Dallas, TX, USA aut NATIONALLICENCE 700 1- Rickert Kim Department of Neurological Surgery, University of Texas—Southwestern Medical Center, Dallas, TX, USA aut NATIONALLICENCE 700 1- Welch Babu Department of Neurological Surgery, University of Texas—Southwestern Medical Center, Dallas, TX, USA aut NATIONALLICENCE 700 1- White Jonathan Department of Neurological Surgery, University of Texas—Southwestern Medical Center, Dallas, TX, USA aut NATIONALLICENCE 700 1- Klinger Daniel Department of Neurological Surgery, University of Texas—Southwestern Medical Center, Dallas, TX, USA aut NATIONALLICENCE 700 1- Boudreaux Benjamin Department of Neurological Surgery, University of Texas—Southwestern Medical Center, Dallas, TX, USA aut NATIONALLICENCE 700 1- Whittemore Brett Department of Neurological Surgery, University of Texas—Southwestern Medical Center, Dallas, TX, USA aut NATIONALLICENCE 700 1- Gu Eugene Division of Neurocritical Care, Department of Neurological Surgery and Neurology & Neurotherapeutics, University of Texas—Southwestern Medical Center, Dallas, TX, USA aut NATIONALLICENCE 773 0- Neurocritical Care Springer US; http://www.springer-ny.com 19/2(2013-10-01), 150-156 1541-6933 19:2<150 2013 19 12028 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer