Acute and Chronic Kidney Dysfunction and Outcome After Stroke Thrombectomy View Full Text


Ontology type: schema:ScholarlyArticle      Open Access: True


Article Info

DATE

2021-01-04

AUTHORS

Simon Fandler-Höfler, Balazs Odler, Markus Kneihsl, Gerit Wünsch, Melanie Haidegger, Birgit Poltrum, Markus Beitzke, Hannes Deutschmann, Christian Enzinger, Alexander R Rosenkranz, Thomas Gattringer

ABSTRACT

Data on the impact of kidney dysfunction on outcome in patients with stroke due to large vessel occlusion are scarce. The few available studies are limited by only considering single kidney parameters measured at one time point. We thus investigated the influence of both chronic kidney disease (CKD) and acute kidney injury (AKI) on outcome after mechanical thrombectomy. We included consecutive patients with anterior circulation large vessel occlusion stroke receiving mechanical thrombectomy at our center over an 8-year period. We extracted clinical data from a prospective registry and investigated kidney serum parameters at admission, the following day and throughout hospital stay. CKD and AKI were defined according to established nephrological criteria. Unfavorable outcome was defined as scores of 3–6 on the modified Rankin Scale 3 months post-stroke. Among 465 patients, 31.8% had an impaired estimated glomerular filtration rate (eGFR) at admission (< 60 ml/min/1.73 m2). Impaired admission eGFR was related to unfavorable outcome in univariable analysis (p = 0.003), but not after multivariable adjustment (p = 0.96). Patients frequently met AKI criteria at admission (24.5%), which was associated with unfavorable outcome in a multivariable model (OR 3.03, 95% CI 1.73–5.30, p < 0.001). Moreover, patients who developed AKI during hospital stay also had a worse outcome (p = 0.002 in multivariable analysis). While CKD was not associated with 3-month outcome, we identified AKI either at admission or throughout the hospital stay as an independent predictor of unfavorable prognosis in this study cohort. This finding warrants further investigation of kidney–brain crosstalk in the setting of acute stroke. More... »

PAGES

791-798

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s12975-020-00881-2

DOI

http://dx.doi.org/10.1007/s12975-020-00881-2

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1134314760

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/33398648


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