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Systemic Inflammation Response Index (SIRI) and contrast-associated AKI in neurointerventional/peri-procedural
Yongxia Ding1, Chenyang Zhao2, Shumeng Zhang1
1Shanxi Medical University, Taiyuan, China.
BMC Neurology
|July 9, 2026
Summary
The systemic inflammation response index (SIRI) is linked to contrast-associated acute kidney injury (CA-AKI) in neurointerventional pathways. Adding SIRI to clinical factors modestly improves CA-AKI risk prediction, warranting further investigation.
Area of Science:
- Nephrology
- Radiology
- Critical Care Medicine
Background:
- Contrast-associated acute kidney injury (CA-AKI) poses a significant clinical challenge in neurointerventional procedures.
- Limited bedside-feasible risk markers exist for CA-AKI.
- The systemic inflammation response index (SIRI) is a potential marker for systemic inflammation.
Purpose of the Study:
- To evaluate the independent association between SIRI and CA-AKI.
- To assess the incremental risk stratification value of SIRI beyond established clinical variables.
- To explore the utility of SIRI in predicting CA-AKI in neurointerventional pathways.
Main Methods:
- Retrospective cohort study of patients undergoing neurointerventional procedures with iodinated contrast.
- CA-AKI defined by a serum creatinine rise ≥ 26.5 µmol/L within 72 hours post-contrast.
- SIRI calculated as (neutrophils × monocytes) / lymphocytes; logistic regression models used for analysis.
- Discrimination (AUC), calibration, and decision curve analysis (DCA) were performed.
Main Results:
- CA-AKI incidence was 17.9%.
- Median SIRI was significantly higher in patients with CA-AKI compared to those without (P < 0.001).
- ln(SIRI) per SD was independently associated with CA-AKI (aOR 1.87). Age, atrial fibrillation, and hypertension were also significant predictors.
- Adding SIRI to a clinical model (age, AF, HTN) improved AUC from 0.675 to 0.732 (ΔAUC +0.057).
Conclusions:
- Admission SIRI is independently associated with CA-AKI in neurointerventional pathways.
- SIRI offers a modest improvement in risk discrimination when combined with pragmatic clinical variables.
- The clinical utility of SIRI for CA-AKI risk stratification is exploratory and requires external validation, with observed benefits being threshold-dependent.
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