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A Large Animal Model for Acute Kidney Injury by Temporary Bilateral Renal Artery Occlusion
Published on: February 2, 2021
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Acute and Chronic Kidney Dysfunction and Outcome After Stroke Thrombectomy.
Simon Fandler-Höfler1, Balazs Odler2, Markus Kneihsl1
1Department of Neurology, Medical University of Graz, Auenbruggerplatz 22, 8036, Graz, Austria.
Translational Stroke Research
|January 5, 2021
Summary
Acute kidney injury (AKI) upon admission or during hospitalization independently predicts poor outcomes in large vessel occlusion stroke patients undergoing mechanical thrombectomy. Chronic kidney disease (CKD) did not show a significant association with 3-month outcomes.
Area of Science:
- Nephrology
- Neurology
- Critical Care Medicine
Background:
- Limited data exists on how kidney dysfunction affects stroke outcomes after mechanical thrombectomy.
- Previous studies often focused on single kidney parameters, neglecting the dynamic nature of kidney injury.
Purpose of the Study:
- To investigate the impact of both chronic kidney disease (CKD) and acute kidney injury (AKI) on patient outcomes following mechanical thrombectomy for large vessel occlusion stroke.
Main Methods:
- Retrospective analysis of 465 patients with anterior circulation large vessel occlusion stroke treated with mechanical thrombectomy over 8 years.
- Evaluation of kidney function parameters at admission, daily, and throughout hospitalization.
- Definition of CKD and AKI based on established nephrological criteria.
- Assessment of unfavorable outcome using the modified Rankin Scale at 3 months post-stroke.
Main Results:
- 31.8% of patients had impaired estimated glomerular filtration rate (eGFR) at admission; this was not an independent predictor of unfavorable outcome after multivariable adjustment.
- 24.5% of patients met AKI criteria at admission, which was independently associated with unfavorable outcomes (OR 3.03).
- Development of AKI during hospitalization also predicted worse outcomes (p=0.002).
Conclusions:
- Acute kidney injury (AKI), whether present on admission or developing during hospitalization, is an independent predictor of unfavorable prognosis in patients with large vessel occlusion stroke undergoing mechanical thrombectomy.
- Chronic kidney disease (CKD) was not significantly associated with 3-month outcomes in this cohort.
- Further research into kidney-brain crosstalk in acute stroke is warranted.
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