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Updated: May 9, 2026
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Published on: July 17, 2016
Acute Kidney Injury and Risk of Adverse Neurocognitive Outcomes: A Systematic Review and Meta-Analysis.
Dearbhla M Kelly1,2, Eoin M Kelleher3,4, Peter M Rothwell1
1Wolfson Centre for the Prevention of Stroke and Dementia, Nuffield Department of Clinical Neurosciences, University of Oxford, United Kingdom.
Neurology
|May 7, 2026
Summary
Acute kidney injury (AKI) significantly increases the risk of stroke, delirium, and dementia. This systematic review highlights AKI as a key indicator of vulnerability to brain injury.
Area of Science:
- Nephrology
- Neurology
- Public Health
Background:
- Chronic kidney disease is a known predictor of neurocognitive decline.
- The impact of acute kidney injury (AKI) on brain health is not well understood.
- This study investigates the link between AKI and subsequent neurological outcomes.
Purpose of the Study:
- To systematically review and meta-analyze the association between AKI and the risk of stroke, delirium, and dementia.
- To quantify the risk of these neurocognitive outcomes following AKI.
- To explore potential risk gradients associated with AKI severity.
Main Methods:
- Systematic review and meta-analysis of 49 studies.
- Searched Ovid MEDLINE and Embase databases.
- Extracted quantitative estimates and adjusted effect sizes (HRs/ORs) with 95% CIs.
- Pooled data using random-effects models.
- Assessed study quality and heterogeneity.
Main Results:
- AKI is associated with increased risk of stroke (HR 1.35), delirium (OR 1.76), and dementia (HR 1.64).
- A dose-response relationship was observed between AKI stage and stroke risk.
- AKI also correlated with higher in-hospital and 90-day mortality post-stroke, and increased 90-day disability.
Conclusions:
- AKI is consistently linked to elevated short-term and long-term neurocognitive risks.
- AKI may serve as an early indicator of susceptibility to acute and chronic brain damage.
- Further research is needed to elucidate mechanisms and develop mitigation strategies.
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