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Master Thesis

Insuffisance rénale aiguë en réanimation et examens avec injection de produits de contraste iodés : une étude cas-témoin chez les patients présentant une hémorragie sous-arachnoïdienne anévrismale

Abstract : Background: Brain imaging with iodinated contrast injection is central to the management of aneurysmal subarachnoid hemorrhage (aSAH). The occurrence of acute kidney injury (AKI) during intensive care unit in this population is poorly documented. Objective: The first objective was to investigate the occurrence of AKI according to the etiological treatment. The secondary objective was to investigate the functional prognosis of patients and the use of iodinated contrast. Type of study: This is a monocentric case-control study. Methods: Adult patients with aSAH managed by neurosurgery or interventional radiology between November 2015 and December 2019 at the University Hospital of Caen were included. 1: 2 matching (Neurosurgical treatment (TCN) n=20; Interventional radiology treatment (TRI) n=40) by gender, age, WFNS score and Fisher score. The primary endpoint was the development of clinical and/or biological AKI at 48 hours according to KDIGO criteria. Results: There was 25% (p=1) AKI at 48 hours in each of the TNC and TRI groups. There was no difference in terms of outcome between these groups. There were significantly more examinations with ionated contrast in the TRI group (2 [1-4] versus 1 [1-3], p<0,001). The onset of AKI at 48 hours was associated with a poor neurological prognosis (93% and 44%, p<0,01). Discussion: AKI associated with ionated contrast is questioned in several studies. The origin of AKI in the ICU is multifactorial, clinical severity including neurological severity is associated with a risk of AKI.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-03563177
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Submitted on : Wednesday, February 9, 2022 - 2:57:14 PM
Last modification on : Saturday, March 26, 2022 - 3:50:28 AM
Long-term archiving on: : Tuesday, May 10, 2022 - 6:51:52 PM

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Antoine Delahaye. Insuffisance rénale aiguë en réanimation et examens avec injection de produits de contraste iodés : une étude cas-témoin chez les patients présentant une hémorragie sous-arachnoïdienne anévrismale. Médecine humaine et pathologie. 2021. ⟨dumas-03563177⟩

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