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A Large Animal Model for Acute Kidney Injury by Temporary Bilateral Renal Artery Occlusion
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Lesión Renal Aguda Asociada a Contraste Después de Trombectomía para Accidente Cerebrovascular Isquémico: Impacto
Ghil Schwarz1,2, Angelo Cascio Rizzo2, Gareth Ambler3
1Stroke Center, Service of Neurology, Department of Clinical Neurosciences, University Hospital of Lausanne and University of Lausanne, Switzerland.
Neurology
|February 19, 2026
Resumen
La lesión renal aguda asociada a contraste (CA-AKI) afecta a casi el 5% de los pacientes sometidos a trombectomía endovascular para accidente cerebrovascular isquémico agudo. Este estudio desarrolló una puntuación de riesgo para identificar a los pacientes con alto riesgo de CA-AKI y resultados adversos asociados.
Sus antecedentes:
- La lesión renal aguda asociada a contraste (CA-AKI) es una complicación conocida de los medios de contraste yodados.
- Su incidencia e impacto en la trombectomía endovascular (EVT) para el accidente cerebrovascular isquémico agudo (AIS) no están bien definidos.
- Actualmente no existe una herramienta de predicción validada para la CA-AKI en esta población de pacientes.
Objetivo del estudio:
- Determinar la incidencia y la significación pronóstica de la CA-AKI en pacientes con AIS tratados con EVT.
- Desarrollar y validar una puntuación predictiva para la CA-AKI en esta cohorte.
Principales métodos:
- Un estudio de cohorte retrospectivo, internacional y multicéntrico de 6.638 pacientes con AIS tratados con EVT.
- CA-AKI definida según los criterios KDIGO (aumento de creatinina ≥0,3 mg/dL o ≥1,5 veces el valor basal en las 48 horas).
- Desarrollo y validación de una puntuación de riesgo preprocedimiento utilizando variables clínicas rutinarias.
Principales resultados:
- La CA-AKI ocurrió en el 4,9% de los pacientes y se asoció de forma independiente con un aumento de la mortalidad hospitalaria y resultados funcionales deficientes a los 90 días (mRS >3).
- Un modelo de riesgo preprocedimiento demostró una discriminación y calibración aceptables (AUC 0,710).
- Los modelos que incluían variables relacionadas con la EVT mostraron un rendimiento similar.
Conclusiones:
- La CA-AKI es un predictor independiente de resultados adversos en pacientes con AIS tratados con EVT.
- Una puntuación de riesgo preprocedimiento simple puede identificar a personas de alto riesgo.
- Esta puntuación puede ayudar a implementar estrategias preventivas para la CA-AKI.
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