Safety of cerebral angiography and neuroendovascular therapy in patients with chronic kidney disease

Neuroradiology. 2018 May;60(5):529-533. doi: 10.1007/s00234-018-1996-2. Epub 2018 Mar 1.


Purpose: Contrast-induced nephropathy is a common clinical concern in patients undergoing neuroendovascular procedures, especially in those with pre-existent kidney disease. We aimed to define the incidence of contrast-induced nephropathy in these high-risk patients in our practice.

Methods: We analyzed data retrospectively from patients undergoing neuroendovascular procedures at two academic medical centers over a 4-year period. Contrast-induced nephropathy was determined by an absolute increase in serum creatinine of 0.5 mg/dL or a rise from its baseline value by ≥ 25%, at 48-72 h after exposure to contrast agent after excluding other causes of renal impairment. High-risk patients were identified as those with pre-procedural estimated glomerular filtration rate < 60 mL/min irrespective of creatinine level, corresponding to stages 3-5 of chronic kidney disease.

Results: One hundred eighty-five high-risk patients undergoing conventional cerebral angiography and neuroendovascular interventions were identified. Only 1 out of 184 (0.54%) high-risk patients developed contrast-induced nephropathy. That one patient had stage 5 chronic kidney disease and multiple other risk factors.

Conclusion: We have observed a very low rate of renal injury in patients with chronic kidney disease, traditionally considered high risk for neuroendovascular procedures. Multiple factors may be responsible in the risk reduction of contrast-induced nephropathy in this patient population.

Keywords: Angiography; Chronic kidney disease; Contrast-induced nephropathy; Neuroendovascular.

Publication types

  • Multicenter Study

MeSH terms

  • Aged
  • Cerebral Angiography*
  • Contrast Media / toxicity*
  • Endovascular Procedures*
  • Female
  • Glomerular Filtration Rate
  • Humans
  • Male
  • Middle Aged
  • Patient Safety*
  • Renal Insufficiency, Chronic / chemically induced*
  • Renal Insufficiency, Chronic / epidemiology
  • Retrospective Studies
  • Triiodobenzoic Acids / toxicity*


  • Contrast Media
  • Triiodobenzoic Acids
  • iodixanol