The following is a summary of “Acute and chronic kidney dysfunction and prognosis following thrombectomy for ischemic stroke,” published in the March 2024 issue of Nephrology by Bobot et al.
Chronic kidney disease increases the risk of stroke, and CKD has been associated with worse outcomes after a stroke.
Researchers conducted a prospective study named RISOTTO, aiming to assess CKD and acute kidney injury (AKI) impact on ischemic stroke outcomes after thrombolysis and/or thrombectomy.
They used a multicenter cohort study involving patients treated for thrombectomy in the acute phase of ischemic stroke. The modified Rankin Scale (mRS) measures outcomes at three months.
The results showed that 280 patients were analyzed, of which 22.6% (n = 59) had CKD. The mRS showed CKD association with a similar functional prognosis (mRS 3-6: 50.0% vs. 41.7%, P = 0.262) but higher mortality (24.2% vs. 9.5%, P=0.004). Patients with CKD exhibited more white matter hyperintensities (Fazekas score: 1.7 ± 0.8 vs. 1.0 ± 0.8, P=0.002), lower initial infarct volume, and reduced recanalization success (86.4% vs. 97.0%, P=0.008). About 20% (n= 47) of patients developed AKI. AKI was associated with poorer 3-month functional outcomes (mRS 3-6: 63.8% vs. 49.0%, P=0.002) and mortality (23.4% vs. 7.7%, P=0.002). AKI appeared as an independent risk factor for poor functional outcome (mRS 3–6: adjOR 2.79 [1.11–7.02], P= 0.029) and mortality ( adjOR 2.52 [1.03–6.18], P= 0.043) at three months, while CKD was not independently associated with 3-month mortality and poor neurological outcome.
Investigators concluded that AKI, not CKD, independently predicts poorer functional outcomes and increased mortality at three months post-stroke.
