Contrast-Induced Renal Injury After Computed Tomography in Ischemic Stroke Patients Receiving Intravenous Thrombolytic Therapy

Aim: This study aimed to evaluate the incidence of contrast-induced nephropathy (CIN) and the factors influencing its development in patients with acute ischemic stroke who were admitted to the emergency department and received intravenous thrombolytic therapy along with intravenous contrast. Materials and Methods: This retrospective observational study included acute ischemic stroke patients aged over 18 years who received intravenous thrombolytic therapy at the emergency department of a tertiary care training and research hospital, a major stroke center in its region. The study was carried out between 1 January 2024 and 1 January 2025. All patients underwent contrast-enhanced brain and supraaortic computed tomography angiography, after receiving a standard dose of intravenous contrast. CIN was defined as either an increase of more than 25% increase in baseline serum creatinine levels or an absolute increase of ≥0.50 mg/dL within 48-72 hours post-contrast administration. Results: A total of 194 patients met the inclusion criteria, with a median age of 74 years, half of whom were female. CIN was observed in 14.9% of patients, although none required dialysis. Patients who developed CIN had significantly lower creatinine levels at admission compared to those who did not (p=0.020). No other parameters, rates, or scores at admission showed statistically significant differences between the groups. Conclusion: The incidence of CIN in patients receiving intravenous thrombolysis for acute ischemic stroke was 14.9%. Patients who developed CIN exhibited significantly lower creatinine levels at admission.