Proteinuria as an independent risk factor for contrast-induced acute kidney injury and mortality in patients with stroke undergoing cerebral angiography

J Neurointerv Surg. 2017 May;9(5):445-448. doi: 10.1136/neurintsurg-2016-012349. Epub 2016 Apr 22.

Abstract

Background: The correlation between proteinuria and contrast-induced acute kidney injury (CI-AKI) in patients with cerebrovascular disease is still unknown.

Objective: To determine whether proteinuria is a risk factor for CI-AKI and death in patients with stroke undergoing cerebral angiography.

Methods: Data from 2015 patients with stroke undergoing cerebral angiography between January 2009 and December 2013 were retrospectively collected. Clinical parameters were obtained from the hospital's computerized database. All variables were analyzed by univariate analysis and multivariate logistic regression analysis.

Results: CI-AKI was seen in 85 patients (4.2%). After adjustment for potential confounding risk factors, patients with proteinuria had a fivefold higher risk of CI-AKI than patients without proteinuria (OR=5.74; 95% CI 2.23 to 14.83; p<0.001). Other independent risk factors for CI-AKI were estimated glomerular filtration rate <60 mL/min/1.73 m2, anemia, and a high National Institute of Health Stroke Scale score. Proteinuria did not increase in-hospital mortality (OR=1.25; 95% CI 0.49 to 3.17; p=0.639) but did increase 1-year mortality (HR=2.30, 95% CI 1.55 to 3.41, p<0.001).

Conclusions: Proteinuria is an independent risk factor for CI-AKI and 1-year mortality in patients with stroke undergoing cerebral angiography. More attention should be paid to the development of CI-AKI in patients with stroke with proteinuria.

Keywords: Angiography; Complication; Intervention; Stroke.

Publication types

  • Observational Study

MeSH terms

  • Acute Kidney Injury / diagnostic imaging
  • Acute Kidney Injury / etiology
  • Acute Kidney Injury / mortality*
  • Adult
  • Aged
  • Cerebral Angiography / adverse effects*
  • Contrast Media / adverse effects*
  • Female
  • Hospital Mortality / trends
  • Humans
  • Male
  • Middle Aged
  • Percutaneous Coronary Intervention
  • Proteinuria / complications
  • Proteinuria / diagnostic imaging
  • Proteinuria / mortality*
  • Retrospective Studies
  • Risk Factors
  • Stroke / diagnostic imaging
  • Stroke / mortality*

Substances

  • Contrast Media