Risk factors for post-contrast acute kidney injury in patients with ischemic stroke after digital subtraction angiography and construction of a prediction model

CHEN Qing-yan; CHEN Xiao-yu; HUANG Xiao-feng; LIU Yan; ZHOU Yong-mei

doi:10.16048/j.issn.2095-5561.2025.03.10

Abstract：Objective To explore the risk factors for post-contrast acute kidney injury(PS-AKI)after digital subtraction angiography(DSA)in patients with ischemic stroke(IS)and to construct a risk prediction model.Methods A total of 325 IS patients who underwent DSA from March 2018 to March 2023 were selected as the research objects.There were 205 males and 120 females,aged(53.79±11.64)years old,with an age range of 42 to 75 years old.The occurrence of PS-AKI were calculated,and general data,laboratory indicators,and imaging related indicators were collected.Binary logistic regression analysis was used to screen risk factors and construct a nomogram model.Results Among the 325 IS patients,21 patients had PS-AKI,with an incidence rate of 6.5％(21/325).There were statistically significant differences in anemia,chronic kidney disease,mannitol use,white blood cell(WBC)counts,uric acid,serum creatinine,blood urea nitrogen,high-sensitivity C-reactive protein,positive urinary protein,contrast agent dose and the number of cases with contrast operation time＞30 min,haemoglobin,albumin and creatinine clearance rate between PS-AKI and non-PS-AKI patients(P＜0.05).Logistic regression analysis showed that chronic kidney disease history,mannitol use,raised WBC and large contrast agent dosage were independent risk factors for PS-AKI in patients(P＜0.05).Hosmer-Lemeshow test showed that prediction model had a good fit(P=0.159).The area under the receiver operating characteristic curve of the prediction model was 0.812(95％CI:0.719-0.877,P＜0.05).The calibration curve showed that the prediction model had good discrimination and accuracy.Conclusion Chronic kidney disease,mannitol use,raised WBC and large contrast agent dosage are independent risk factors for PS-AKI after DSA in IS patients.The constructed risk prediction model can effectively predict the occurrence of early PS-AKI.