High White Blood Cell Count Is a Risk Factor for Contrast-Induced Nephropathy following Mechanical Thrombectomy for Acute Ischemic Stroke

Abstract

Background: Although mechanical thrombectomy is a standard endovascular therapy for patients with acute ischemic stroke (AIS), the incidence of and risk factors for contrast-induced nephropathy (CIN) following mechanical thrombectomy are infrequently reported. Objectives: The aim of this study was to investigate the incidence and risk factors for CIN following mechanical thrombectomy for AIS, and whether the incidence of CIN is related to a poor prognosis. Methods: We examined consecutive patients who underwent a mechanical thrombectomy in the period from January 2014 to March 2018. The patients' clinical backgrounds, treatments, and clinical prognoses were analyzed. CIN was defined as an increase in the serum creatinine level of ≥44.2 μmol/L (0.5 mg/dL) or 25% above baseline within 72 h after exposure to the contrast medium. Results: In total, 80 patients (46 men and 34 women aged 74.5 ± 11.5 years) who met our inclusion criteria were analyzed. CIN occurred in 8.8% (7/80) of the patients following mechanical thrombectomy. Although no patients needed permanent dialysis, 1 required temporary dialysis. The median amount of contrast medium was 109 mL. A comparison between the groups with and without CIN showed a significant difference in white blood cell (WBC) count at the time of admission (11.6 ± 2.7 × 10 3 /μL and 8.1 ± 2.7 × 10 3 /μL; p < 0.01) and

The Predictive Value of Myeloperoxidase for Contrast-Induced Nephropathy After Percutaneous Coronary Intervention in Patients with Acute Myocardial Infarction

“…Yamamoto et al found, through multivariate analysis, that high preoperative WBC count was a novel risk factor for developing CIN following mechanical thrombectomyan. 33 Similar reports show an increase in inflammation-related molecules in CIN after PCI, including WBC counts (especially neutrophils). 34 Inflammatory cells cause the release of oxygen free radicals, vasoconstrictors, leukotrienes and thromboxane, leading to kidney damage.…”

Risk factors of acute kidney injury during hospitalization in acute ischaemic stroke patients undergoing mechanical thrombectomy

“…Yoo et al ., in a study of 601 MT-treated patients, concluded that factors independently associated with AKI were diabetes, total contrast dose and unsuccessful reperfusion [ 12 ]. In a study by Yamamoto et al ., including 80 patients after MT, contrast-induced nephropathy was independently predicted by white blood cell count and the quotient of contrast volume and estimated glomerular filtration rate [ 17 ]. In a study by Weber et al among 1017 MT-treated AIS patients those who developed AKI compared to those without AKI significantly more often suffered from diabetes and chronic kidney disease and more frequently had a tandem occlusion, but multivariate logistic regression analysis revealed no significant independent risk factors for AKI [ 7 ].…”

Role of modified hydration for preventing contrast-associated acute kidney injury in patients with ST-segment elevation myocardial infarction after primary percutaneous coronary intervention

“…In addition, inflammation may play an important role in the initiation and extension phases of CA-AKI. Inflammatory cells infiltrate the interstitium of the kidney via cytokines produced by renal endothelial cells, and cause the release of oxygen radicals, vasoconstrictors, and thromboxanes, leading to kidney damage [ 24 , 25 ]. STEMI patients had increased systemic inflammatory responses.…”