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

April 16, 2026 updated by: Fatma Acil,MD, Saglik Bilimleri Universitesi Gazi Yasargil Training and Research Hospital

The Impact of Serum Electrolyte Levels on the Risk of Contrast-Induced Nephropathy in Patients With Acute Ischemic Stroke Undergoing Endovascular Therapy

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.

Study Overview

Status

Not yet recruiting

Conditions

Intervention / Treatment

Detailed Description

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.

Study Type

Observational

Enrollment (Estimated)

250

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Contact Backup

Study Locations

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

N/A

Sampling Method

Non-Probability Sample

Study Population

This study includes adult patients (≥18 years) with acute ischemic stroke who underwent endovascular therapy at a tertiary referral center between 2018 and 2026. Patients with sufficient clinical and laboratory data, including pre- and post-procedural serum creatinine measurements, will be eligible for inclusion.

The cohort reflects a real-world population of patients undergoing EVT, encompassing a wide range of demographic and clinical characteristics, including common vascular comorbidities. Patients will be stratified according to the development of contrast-induced acute kidney injury (CI-AKI) for comparative analyses.

Description

Inclusion Criteria:

  • Adults aged 18 years or older
  • Patients diagnosed with acute ischemic stroke
  • Patients who underwent endovascular therapy for acute ischemic stroke between 2018 and 2026
  • Patients with a baseline NIHSS score of 6 or higher
  • Patients who received iodinated contrast medium during the endovascular procedure
  • Patients managed under general anesthesia
  • Patients with available pre-procedural and post-procedural serum creatinine measurements sufficient to assess contrast-induced acute kidney injury

Exclusion Criteria:

  • Age younger than 18 years
  • Pre-existing acute kidney injury or chronic kidney disease meeting KDIGO stage 1-3 before endovascular therapy
  • APACHE score greater than 25 at the time of the procedure
  • Known allergy or hypersensitivity to iodinated contrast media
  • Exposure to iodinated contrast media within the previous 2 weeks
  • Use of nephrotoxic medications within the previous 2 weeks
  • History of myocardial infarction or previous stroke
  • Use of vasopressor/inotropic agents such as dopamine at the time of the procedure
  • Systemic steroid use at the time of the procedure
  • Incomplete medical records or missing laboratory data required for evaluation of CI-AKI

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

Cohorts and Interventions

Group / Cohort
Intervention / Treatment
CI-AKI Group
Patients who developed contrast-induced acute kidney injury (CI-AKI) following endovascular therapy for acute ischemic stroke, defined by an increase in serum creatinine levels according to established diagnostic criteria after contrast exposure. These patients were identified based on post-procedural renal function changes and included in the analysis to evaluate clinical, laboratory, and procedural factors associated with CI-AKI development.
Other: No intervention (observational cohort study)
No experimental or therapeutic intervention was assigned. This observational retrospective cohort study evaluated patients undergoing endovascular therapy for acute ischemic stroke, who were subsequently categorized based on the presence or absence of contrast-induced acute kidney injury (CI-AKI). The study analyzed demographic, clinical, laboratory (including serum electrolyte levels) and procedural variables to identify potential risk factors associated with CI-AKI development.
Non-CI-AKI Group
Patients who underwent endovascular therapy for acute ischemic stroke but did not develop contrast-induced acute kidney injury based on post-procedural serum creatinine measurements.
Other: No intervention (observational cohort study)
No experimental or therapeutic intervention was assigned. This observational retrospective cohort study evaluated patients undergoing endovascular therapy for acute ischemic stroke, who were subsequently categorized based on the presence or absence of contrast-induced acute kidney injury (CI-AKI). The study analyzed demographic, clinical, laboratory (including serum electrolyte levels) and procedural variables to identify potential risk factors associated with CI-AKI development.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Incidence of contrast-induced acute kidney injury (CI-AKI)
Time Frame: Within 48-72 hours after contrast exposure
CI-AKI will be identified based on post-procedural serum creatinine changes after contrast exposure according to established diagnostic criteria.
Within 48-72 hours after contrast exposure

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
90-day mortality
Time Frame: Within 90 days after endovascular therapy
All-cause mortality occurring within 90 days after endovascular therapy in patients with and without contrast-induced acute kidney injury (CI-AKI).
Within 90 days after endovascular therapy
Dialysis dependency in patients with CI-AKI
Time Frame: Within 90 days after endovascular therapy
Requirement for renal replacement therapy (hemodialysis) within 90 days after endovascular therapy in patients who developed contrast-induced acute kidney injury (CI-AKI)
Within 90 days after endovascular therapy
Change in serum creatinine
Time Frame: Baseline to 48-72 hours after endovascular therapy
Change in serum creatinine levels from baseline to post-procedural measurements following contrast exposure.
Baseline to 48-72 hours after endovascular therapy
Association between serum electrolyte levels and CI-AKI
Time Frame: Baseline (pre-procedural measurements)
Evaluation of the relationship between baseline serum electrolyte levels (sodium, potassium, chloride, calcium, magnesium, phosphate) and the development of contrast-induced acute kidney injury.
Baseline (pre-procedural measurements)
Length of hospital stay
Time Frame: Within 90 days after endovascular therapy
Total duration of hospitalization in days, compared between patients with and without CI-AKI.
Within 90 days after endovascular therapy
Inflammatory markers and CI-AKI relationship
Time Frame: Baseline (pre-procedural measurements)
Association between inflammatory markers (e.g., C-reactive protein, procalcitonin) and the development of CI-AKI.
Baseline (pre-procedural measurements)
Change in estimated glomerular filtration rate (eGFR)
Time Frame: Baseline to 48-72 hours after endovascular therapy
Change in estimated glomerular filtration rate (eGFR) from baseline to post-procedural measurements following contrast exposure
Baseline to 48-72 hours after endovascular therapy

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Saglik Bilimleri Universitesi Gazi Yasargil Training and Research Hospital

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Estimated)

April 20, 2026

Primary Completion (Estimated)

May 10, 2026

Study Completion (Estimated)

May 10, 2026

Study Registration Dates

First Submitted

April 2, 2026

First Submitted That Met QC Criteria

April 16, 2026

First Posted (Actual)

April 22, 2026

Study Record Updates

Last Update Posted (Actual)

April 22, 2026

Last Update Submitted That Met QC Criteria

April 16, 2026

Last Verified

April 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • 27.012.2026-37

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

UNDECIDED

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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