Incidence of acute kidney injury in patients with acute ischaemic stroke undergoing CT angiography (CTA) and CT perfusion (CTP): a systematic review and meta-analysis.

Autor:	Kamran A; Department of Medicine, Dow University of Health Sciences, Karachi, Pakistan., Paryani NS; Department of Medicine, Dow University of Health Sciences, Karachi, Pakistan., Suri NF; Department of Medicine, Dow University of Health Sciences, Karachi, Pakistan., Khan J; Department of Medicine, Dow University of Health Sciences, Karachi, Pakistan., Amir F; Department of Medicine, Dow University of Health Sciences, Karachi, Pakistan., Mehmood M; Department of Medicine, Dow University of Health Sciences, Karachi, Pakistan., Lashkerwala SS; Department of Medicine, Dow University of Health Sciences, Karachi, Pakistan., Hayat J; Department of Medicine, Dow University of Health Sciences, Karachi, Pakistan., Marsia S; Department of Neurology, Corewell Health West Michigan, Grand Rapids, Michigan, USA.
Jazyk:	angličtina
Zdroj:	BMJ neurology open [BMJ Neurol Open] 2024 Apr 25; Vol. 6 (1), pp. e000558. Date of Electronic Publication: 2024 Apr 25 (Print Publication: 2024).
DOI:	10.1136/bmjno-2023-000558
Abstrakt:	Background and Purpose: We conducted a systematic review and meta-analysis to assess the incidence of acute kidney injury (AKI) in patients undergoing CT angiography (CTA) and CT perfusion (CTP) for acute ischaemic stroke (AIS). Concerns over contrast-induced nephropathy (CIN) often lead medical centres to mandate pre-imaging serum creatinine level assessments, causing unnecessary delays. We aim to confirm further the practice of conducting CTA/CTP without first testing creatinine. Methods: We searched PubMed, Cochrane Central and Scopus from inception until March 2023 for studies reporting on AKI in patients with AIS receiving CTA/CTP. Outcomes of interest were (1) the odds of AKI in patients receiving CTA/CTP versus non-contrast CT and (2) the overall incidence of AKI and haemodialysis in patients with AIS undergoing CTA/CTP. Results: Results were pooled using a random effects model. 13 studies were included (5 cohort and 8 single-arm studies) with 5104 patients in total, out of which 4347 patients received CTA/CTP and 757 patients received no contrast. In case-control studies, 4.8% (OR=0.66, 95% CI 0.35 to 1.22, Z=1.32, p=0.19) of patients who received CTA/CTP developed AKI, compared with 7.7% of patients in the control group. Temporary haemodialysis was required for two patients in the analysed studies. Conclusions: Non-randomised evidence suggests that CTA/CTP is not associated with a statistically significant increase in the risk of AKI in patients with stroke. Further well-designed prospective studies are required to explore potential risk factors of CIN in specific patient populations such as diabetes mellitus and chronic kidney disease. Competing Interests: Competing interests: None declared. (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze:	MEDLINE
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