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Updated: Jan 28, 2026
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Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
Published on: January 18, 2018
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Contrast-Associated Acute Kidney Injury After Endovascular Therapy for Acute Ischemic Stroke: A Meta-Analysis
Hong-Jie Jhou1,2, Po-Huang Chen3, Li-Yu Yang1,2
1Department of Neurology Changhua Christian Hospital Changhua Taiwan.
Stroke (Hoboken, N.J.)
|January 26, 2026
Summary
The risk of contrast-associated acute kidney injury (CA-AKI) and renal replacement therapy (RRT) after endovascular therapy (EVT) for acute ischemic stroke is low. Treatment for EVT should not be delayed due to concerns about renal function.
Area of Science:
- Nephrology
- Neurology
- Radiology
Background:
- Acute ischemic stroke (AIS) management often involves endovascular therapy (EVT).
- Contrast media used in EVT poses a potential risk for kidney injury.
- Contrast-associated acute kidney injury (CA-AKI) and the need for renal replacement therapy (RRT) are potential complications.
Purpose of the Study:
- To investigate the incidence of CA-AKI and RRT following EVT in patients with AIS.
- To identify factors associated with CA-AKI and RRT in this patient population.
Main Methods:
- A systematic literature search was conducted across PubMed, Cochrane Library, and Web of Science until July 2021.
- Meta-analysis using a random-effects model with double arcsine transformation was employed to pool incidence rates.
- Subgroup and meta-regression analyses were performed to explore influencing factors.
Main Results:
- Fifteen studies comprising 27,246 patients met the inclusion criteria.
- The pooled incidence of CA-AKI was 5.0% (95% CI, 2.1%-8.9%) and RRT was 0.2% (95% CI, 0.0%-0.4%).
- Diabetes was associated with increased CA-AKI rates (P=0.002), while baseline renal function and contrast volume were not significant factors.
Conclusions:
- The incidence of CA-AKI and RRT after EVT for AIS is low.
- Concerns regarding renal function should not impede timely EVT for eligible patients.
- Further research may explore specific risk mitigation strategies for diabetic patients.
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