TY - JOUR T1 - A 5-Item Prediction Rule to Identify Severe Renal Dysfunction in Patients with Acute Stroke JF - American Journal of Neuroradiology JO - Am. J. Neuroradiol. SP - 1449 LP - 1454 DO - 10.3174/ajnr.A3013 VL - 33 IS - 8 AU - M.D.I. Vergouwen AU - J. Fang AU - L.K. Casaubon AU - M.K. Kapral AU - M. Stamplecoski AU - A. Robertson AU - F.L. Silver Y1 - 2012/09/01 UR - http://www.ajnr.org/content/33/8/1449.abstract N2 - BACKGROUND AND PURPOSE: Although patients with severe renal dysfunction who receive iodinated contrast are at high risk of CIN, contrast-enhanced CT scans are often obtained without prior knowledge of kidney function in patients with acute stroke. We aimed to develop a tool to identify patients with acute stroke at a high risk of CIN in the absence of a recent GFR. MATERIALS AND METHODS: We used the RCSN (9872 patients) and OSA (2544 patients) for our derivation and validation cohort, respectively. A multivariable logistic regression model was performed to develop a predictive tool to identify severe renal dysfunction (defined as a GFR < 30 mL/min/1.73 m2). RESULTS: The overall prevalence of severe renal dysfunction was 4.9% and 5.2% in the derivation and validation cohort, respectively. The prediction rule was designed as follows: (age in years) + (5 points for women) + (5 points for history of diabetes mellitus) + (15 points for preadmission insulin use) + (10 points for history of hypertension). The prevalence of severe renal dysfunction is negligible in patients with a total score of ≤70 (≤0.005%–0.7%) but increases with higher Renal Risk Scores (eg, scores 71–80: 2.1%–2.2%; scores 91–100: 6.6%–7.1%; scores 111–120: 15.9%–28.1%). CONCLUSIONS: The Renal Risk Score is a validated tool that helps clinicians select which patients with stroke can safely proceed to contrast-enhanced brain imaging without waiting for laboratory evidence of good renal function. CIconfidence intervalCINcontrast-induced nephropathyCKD-EPIChronic Kidney Disease Epidemiology CollaborationGFRglomerular filtration rateIQRinterquartile rangeORodds ratioOSAOntario Stroke AuditRCSNRegistry of the Canadian Stroke Network ER -