DOI: 10.1177/19714009261473175 ISSN: 1971-4009

Incidence of contrast-associated acute kidney injury differs by procedure type in neuroendovascular surgery

Yaxiaerjiang Yalikun, Masakazu Hayashida, Masataka Fukuda, Atsuko Hara, Chieko Mitaka, Izumi Kawagoe
Show PDF Cite

Background

Evidence regarding the incidence and risk factors of contrast-associated acute kidney injury (CA-AKI) after neuroendovascular surgery (NES) remains limited. This study aimed to identify risk factors for CA-AKI after NES.

Methods

We retrospectively analyzed adolescent and adult patients who underwent NES under general anesthesia at our institution between 2014 and 2024. CA-AKI was defined as a serum creatinine increase ≥0.3 mg/dL within 48 h, or ≥1.5 times baseline within 7 days. Risk factors were assessed using logistic regression.

Results

Among 2412 patients (840 males) aged 10–91 years, NES indications included unruptured cerebral aneurysm (UCA, n = 1808), carotid artery stenosis (CAS, n = 212), dural arteriovenous fistula (DAVF, n = 183), aneurysmal subarachnoid hemorrhage (aSAH, n = 107), and arteriovenous malformation (AVM, n = 102). The overall incidence of CA-AKI was 1.91%. By lesion type, incidences were 9.35% (aSAH), 9.91% (CAS), 2.94% (AVM), 0.55% (DAVF), and 0.61% (UCA). Multivariate analysis identified diabetes mellitus (odds ratio [OR], 2.414; 95% confidence interval [CI], 1.099–5.306; p = .028), lower preoperative total protein (OR, 0.447; 95% CI, 0.265–0.754; p = .003), higher preoperative creatinine (OR, 5.692; 95% CI, 2.962–10.938; p = <0.001), and lesion type (aSAH vs. UCA: OR, 17.672; CAS vs. UCA: OR, 9.551; both p < .001) as significant predictors.

Conclusion

Patients undergoing NES for aSAH or CAS were associated with an increased risk of CA-AKI, independent of known risk factors. To our knowledge, this is the first study to demonstrate lesion-specific differences in CA-AKI risk after NES.

More from our Archive