Serum Electrolytes and Contrast-Induced Nephropathy in Acute Ischemic Stroke Patients Undergoing Endovascular Treatment

Overview

This study aims to evaluate the relationship between serum electrolyte levels and the development of contrast-induced acute kidney injury (CI-AKI) in patients with acute ischemic stroke undergoing endovascular therapy (EVT). Contrast-induced nephropathy remains a significant complication associated with endovascular procedures and is linked to increased morbidity and mortality. While several risk factors have been identified, the role of serum electrolyte imbalances in the development of CI-AKI has not been fully elucidated. In this retrospective cohort study, patients treated with EVT between 2018 and 2026 will be analyzed. Patients will be classified based on the presence or absence of CI-AKI according to changes in serum creatinine levels. Demographic data, comorbidities, laboratory parameters-including serum electrolytes-and procedural variables will be compared between groups. The primary objective is to determine whether serum electrolyte levels are associated with the risk of CI-AKI. Secondary objectives include evaluating 90-day mortality and dialysis dependency in patients who develop CI-AKI.

This retrospective cohort study is designed to evaluate the association between serum electrolyte levels and the development of contrast-induced acute kidney injury (CI-AKI) in patients undergoing endovascular therapy (EVT) for acute ischemic stroke. Endovascular treatment has become a standard of care for acute ischemic stroke; however, the use of iodinated contrast media carries a risk of nephrotoxicity. Contrast-induced acute kidney injury remains a clinically significant complication and is associated with prolonged hospitalization, increased healthcare costs, and higher mortality rates. Although several well-established risk factors for CI-AKI have been identified, including baseline renal dysfunction, diabetes mellitus, and contrast volume, the role of serum electrolyte imbalances has not been clearly defined. Electrolyte disturbances may influence renal perfusion, tubular function, and systemic hemodynamics, potentially contributing to the pathophysiology of CI-AKI. Therefore, identifying electrolyte-related risk factors may help improve risk stratification and guide preventive strategies in high-risk populations. In this study, patients who underwent EVT between 2018 and 2026 will be included. Prospectively collected clinical data will be analyzed retrospectively. Patients will be divided into two groups based on the development of CI-AKI, defined according to changes in serum creatinine levels following contrast exposure. Comparative analyses will be performed between patients with and without CI-AKI to identify potential predictors. Multivariate regression analysis may be used to determine independent risk factors associated with CI-AKI development. The findings of this study are expected to provide clinically relevant insights into the role of electrolyte balance in the development of CI-AKI and may contribute to improved peri-procedural risk assessment and patient management strategies in acute ischemic stroke populations undergoing endovascular therapy.