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Updated: Aug 6, 2026
09:02
A Large Animal Model for Acute Kidney Injury by Temporary Bilateral Renal Artery Occlusion
Published on: February 2, 2021
Acute Kidney Injury After Intensive Blood Pressure Lowering Following Successful Endovascular Thrombectomy
Jae Wook Jung1, Hee Byung Koh2, Young Dae Kim1
1Department of Neurology (J.W.J., Y.D.K., J.N.H., H.L., H.S.N.), Yonsei University College of Medicine, Seoul, Korea.
Stroke
|July 24, 2026
Summary
Intensive blood pressure management after stroke thrombectomy increased acute kidney injury (AKI) risk. AKI was linked to poorer functional outcomes and higher mortality, highlighting its role as a marker of hemodynamic vulnerability.
Area of Science:
- Neurology
- Nephrology
- Critical Care Medicine
Background:
- The impact of post-thrombectomy blood pressure management on acute kidney injury (AKI) in acute ischemic stroke patients is understudied.
- Understanding this relationship is crucial for optimizing patient care after endovascular thrombectomy.
Purpose of the Study:
- To investigate the association between intensive versus conventional blood pressure management and AKI development after successful endovascular thrombectomy.
- To examine the relationship between AKI and functional independence at 3 months post-stroke.
Main Methods:
- Secondary analysis of the OPTIMAL-BP trial involving patients with large-vessel occlusion stroke treated with thrombectomy.
- Randomization to intensive (systolic BP <140 mmHg) or conventional (systolic BP 140-180 mmHg) blood pressure management for 24 hours.
- AKI defined by KDIGO criteria; functional independence by modified Rankin Scale score; multivariable logistic regression used for analysis.
Main Results:
- Intensive BP management was associated with a higher incidence of AKI within 7 days (13.6% vs 6.4%) and 2 days.
- Patients with AKI showed significantly lower rates of functional independence (13.8% vs 49.0%) and higher stroke-related mortality (37.9% vs 3.1%) at 3 months.
- Sensitivity analysis showed a non-significant trend towards increased AKI with intensive management.
Conclusions:
- Aggressive blood pressure lowering post-thrombectomy is linked to an increased risk of AKI, even mild cases.
- AKI following thrombectomy is associated with adverse neurological outcomes and mortality.
- AKI may serve as an indicator of systemic hemodynamic vulnerability in stroke patients undergoing intensive BP management.
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