Abstract Body: Introduction: In 2020 the National Kidney Foundation and American College of Radiology released statements stating the prevalence of contrast induced acute kidney injury (CI-AKI) is much lower than historically reported, this had led to a dramatic shift in thinking. We sought to examine if patients with CKD and normal renal function experienced CI-AKI when undergoing CTA in suspected acute stroke.

Methods: This study aimed to evaluate the impact of CTA contrast on kidney function, specifically assessing whether contrast leads to progression of CKD or acute kidney injury (AKI) in patients with suspected stroke. Data were collected on creatinine levels of patients before and after receiving CTA contrast, including participants with both normal kidney function and underlying CKD.

Inclusion Criteria: Patients aged 18 years and older, presenting with stroke-like symptoms and undergoing CTA were enrolled. Patients with ESRD on dialysis were excluded.

A total of 197 patients were included from Texas Health Resources Denton, of which 49 (24%) had CKD, while 148 (75%) patients had normal kidney function. The outcome measured was the change in creatinine levels post-CTA.

Results: Data analysis revealed no significant change in creatinine levels in patients with underlying CKD or those with normal kidney function after CTA contrast administration. Paired two-sided t-tests (significance level 0.05) were conducted to compare pre- and post-CTA creatinine levels, showing statistically significant changes with all 95% confidence intervals reflecting negative estimates, indicating no adverse impact from CTA contrast.

If any, study showed statistically significant decreases in creatinine levels post-CTA supporting the conclusion that CTA contrast does not harm kidney function. Furthermore, CI-AKI has been a misguided term and should only be considered after ruling out all other potential causes of elevated creatinine levels

Conclusions: This study supports the safe use of CTA contrast in suspected stroke patients, including those with CKD, without increasing the risk of AKI or CKD progression. These findings should reassure physcians and help overcome hesitancy in the use of CTA in CKD patients. Earlier imaging and subsequent timely intervention are associated with better outcomes, This research serves as a pilot for larger studies, advocating that patients with suspected stroke, akin to those with heart attacks, should undergo CTA regardless of creatinine levels.