The Impact of Serum Electrolyte Levels on the Risk of Contrast-Induced Nephropathy in Patients With Acute Ischemic Stroke Undergoing Endovascular Therapy
试验速览
- 阶段
- 不适用
- 状态
- 尚未招募
- 发起方
- 入组人数
- 250
- 试验地点
- 1
- 主要终点
- Incidence of contrast-induced acute kidney injury (CI-AKI)
研究概览
简要总结
This study aims to evaluate the relationship between serum electrolyte levels and the development of contrast-induced acute kidney injury (CI-AKI) in patients with acute ischemic stroke undergoing endovascular therapy (EVT).
Contrast-induced nephropathy remains a significant complication associated with endovascular procedures and is linked to increased morbidity and mortality. While several risk factors have been identified, the role of serum electrolyte imbalances in the development of CI-AKI has not been fully elucidated.
In this retrospective cohort study, patients treated with EVT between 2018 and 2026 will be analyzed. Patients will be classified based on the presence or absence of CI-AKI according to changes in serum creatinine levels. Demographic data, comorbidities, laboratory parameters-including serum electrolytes-and procedural variables will be compared between groups.
The primary objective is to determine whether serum electrolyte levels are associated with the risk of CI-AKI. Secondary objectives include evaluating 90-day mortality and dialysis dependency in patients who develop CI-AKI.
详细描述
This retrospective cohort study is designed to evaluate the association between serum electrolyte levels and the development of contrast-induced acute kidney injury (CI-AKI) in patients undergoing endovascular therapy (EVT) for acute ischemic stroke.
Endovascular treatment has become a standard of care for acute ischemic stroke; however, the use of iodinated contrast media carries a risk of nephrotoxicity. Contrast-induced acute kidney injury remains a clinically significant complication and is associated with prolonged hospitalization, increased healthcare costs, and higher mortality rates. Although several well-established risk factors for CI-AKI have been identified, including baseline renal dysfunction, diabetes mellitus, and contrast volume, the role of serum electrolyte imbalances has not been clearly defined.
Electrolyte disturbances may influence renal perfusion, tubular function, and systemic hemodynamics, potentially contributing to the pathophysiology of CI-AKI. Therefore, identifying electrolyte-related risk factors may help improve risk stratification and guide preventive strategies in high-risk populations.
In this study, patients who underwent EVT between 2018 and 2026 will be included. Prospectively collected clinical data will be analyzed retrospectively. Patients will be divided into two groups based on the development of CI-AKI, defined according to changes in serum creatinine levels following contrast exposure.
Comparative analyses will be performed between patients with and without CI-AKI to identify potential predictors. Multivariate regression analysis may be used to determine independent risk factors associated with CI-AKI development.
研究设计
- 研究类型
- Observational
- 观察模型
- Cohort
- 时间视角
- Retrospective
入排标准
- 年龄范围
- 18 Years 至 100 Years（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Adults aged 18 years or older
- •Patients diagnosed with acute ischemic stroke
- •Patients who underwent endovascular therapy for acute ischemic stroke between 2018 and 2026
- •Patients with a baseline NIHSS score of 6 or higher
- •Patients who received iodinated contrast medium during the endovascular procedure
- •Patients managed under general anesthesia
- •Patients with available pre-procedural and post-procedural serum creatinine measurements sufficient to assess contrast-induced acute kidney injury
排除标准
- •Age younger than 18 years
- •Pre-existing acute kidney injury or chronic kidney disease meeting KDIGO stage 1-3 before endovascular therapy
- •APACHE score greater than 25 at the time of the procedure
- •Known allergy or hypersensitivity to iodinated contrast media
- •Exposure to iodinated contrast media within the previous 2 weeks
- •Use of nephrotoxic medications within the previous 2 weeks
- •History of myocardial infarction or previous stroke
- •Use of vasopressor/inotropic agents such as dopamine at the time of the procedure
- •Systemic steroid use at the time of the procedure
- •Incomplete medical records or missing laboratory data required for evaluation of CI-AKI
研究组 & 干预措施
CI-AKI Group
Patients who developed contrast-induced acute kidney injury (CI-AKI) following endovascular therapy for acute ischemic stroke, defined by an increase in serum creatinine levels according to established diagnostic criteria after contrast exposure. These patients were identified based on post-procedural renal function changes and included in the analysis to evaluate clinical, laboratory, and procedural factors associated with CI-AKI development.
干预措施: No intervention (observational cohort study) (Other)
Non-CI-AKI Group
Patients who underwent endovascular therapy for acute ischemic stroke but did not develop contrast-induced acute kidney injury based on post-procedural serum creatinine measurements.
干预措施: No intervention (observational cohort study) (Other)
结局指标
主要结局
Incidence of contrast-induced acute kidney injury (CI-AKI)
时间窗: Within 48-72 hours after contrast exposure
CI-AKI will be identified based on post-procedural serum creatinine changes after contrast exposure according to established diagnostic criteria.
次要结局
- 90-day mortality(Within 90 days after endovascular therapy)
- Dialysis dependency in patients with CI-AKI(Within 90 days after endovascular therapy)
- Change in serum creatinine(Baseline to 48-72 hours after endovascular therapy)
- Association between serum electrolyte levels and CI-AKI(Baseline (pre-procedural measurements))
- Length of hospital stay(Within 90 days after endovascular therapy)
- Inflammatory markers and CI-AKI relationship(Baseline (pre-procedural measurements))
- Change in estimated glomerular filtration rate (eGFR)(Baseline to 48-72 hours after endovascular therapy)
研究者
Fatma Acil,MD
Principal Investigator
Saglik Bilimleri Universitesi Gazi Yasargil Training and Research Hospital