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SHR Neuro Krebs Kardio Lipid Stoffw Microb

Fandler-Höfler, S; Odler, B; Kneihsl, M; Wünsch, G; Haidegger, M; Poltrum, B; Beitzke, M; Deutschmann, H; Enzinger, C; Rosenkranz, AR; Gattringer, T.
Acute and Chronic Kidney Dysfunction and Outcome After Stroke Thrombectomy.
Transl Stroke Res. 2021; 12(5):791-798 Doi: 10.1007/s12975-020-00881-2 [OPEN ACCESS]
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Führende Autor*innen der Med Uni Graz

Fandler-Höfler Simon

Gattringer Thomas

Co-Autor*innen der Med Uni Graz

Beitzke Markus

Deutschmann Hannes

Enzinger Christian

Haidegger Melanie

Kneihsl Markus

Odler Balazs

Poltrum Birgit

Rosenkranz Alexander

Wünsch Gerit

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Abstract:

Data on the impact of kidney dysfunction on outcome in patients with stroke due to large vessel occlusion are scarce. The few available studies are limited by only considering single kidney parameters measured at one time point. We thus investigated the influence of both chronic kidney disease (CKD) and acute kidney injury (AKI) on outcome after mechanical thrombectomy. We included consecutive patients with anterior circulation large vessel occlusion stroke receiving mechanical thrombectomy at our center over an 8-year period. We extracted clinical data from a prospective registry and investigated kidney serum parameters at admission, the following day and throughout hospital stay. CKD and AKI were defined according to established nephrological criteria. Unfavorable outcome was defined as scores of 3-6 on the modified Rankin Scale 3 months post-stroke. Among 465 patients, 31.8% had an impaired estimated glomerular filtration rate (eGFR) at admission (< 60 ml/min/1.73 m²). Impaired admission eGFR was related to unfavorable outcome in univariable analysis (p = 0.003), but not after multivariable adjustment (p = 0.96). Patients frequently met AKI criteria at admission (24.5%), which was associated with unfavorable outcome in a multivariable model (OR 3.03, 95% CI 1.73-5.30, p < 0.001). Moreover, patients who developed AKI during hospital stay also had a worse outcome (p = 0.002 in multivariable analysis). While CKD was not associated with 3-month outcome, we identified AKI either at admission or throughout the hospital stay as an independent predictor of unfavorable prognosis in this study cohort. This finding warrants further investigation of kidney-brain crosstalk in the setting of acute stroke.

Find related publications in this database (Keywords)

Stroke

Ischemic stroke

Mechanical thrombectomy

Endovascular therapy

Acute kidney injury

Chronic kidney disease

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