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Acute and Chronic Kidney Dysfunction and Outcome After Stroke Thrombectomy
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)...
Autores principales: | , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer US
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8421282/ https://www.ncbi.nlm.nih.gov/pubmed/33398648 http://dx.doi.org/10.1007/s12975-020-00881-2 |
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author | Fandler-Höfler, Simon Odler, Balazs Kneihsl, Markus Wünsch, Gerit Haidegger, Melanie Poltrum, Birgit Beitzke, Markus Deutschmann, Hannes Enzinger, Christian Rosenkranz, Alexander R Gattringer, Thomas |
author_facet | Fandler-Höfler, Simon Odler, Balazs Kneihsl, Markus Wünsch, Gerit Haidegger, Melanie Poltrum, Birgit Beitzke, Markus Deutschmann, Hannes Enzinger, Christian Rosenkranz, Alexander R Gattringer, Thomas |
author_sort | Fandler-Höfler, Simon |
collection | PubMed |
description | 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 m(2)). 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. |
format | Online Article Text |
id | pubmed-8421282 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Springer US |
record_format | MEDLINE/PubMed |
spelling | pubmed-84212822021-09-09 Acute and Chronic Kidney Dysfunction and Outcome After Stroke Thrombectomy Fandler-Höfler, Simon Odler, Balazs Kneihsl, Markus Wünsch, Gerit Haidegger, Melanie Poltrum, Birgit Beitzke, Markus Deutschmann, Hannes Enzinger, Christian Rosenkranz, Alexander R Gattringer, Thomas Transl Stroke Res Original Article 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 m(2)). 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. Springer US 2021-01-04 2021 /pmc/articles/PMC8421282/ /pubmed/33398648 http://dx.doi.org/10.1007/s12975-020-00881-2 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . |
spellingShingle | Original Article Fandler-Höfler, Simon Odler, Balazs Kneihsl, Markus Wünsch, Gerit Haidegger, Melanie Poltrum, Birgit Beitzke, Markus Deutschmann, Hannes Enzinger, Christian Rosenkranz, Alexander R Gattringer, Thomas Acute and Chronic Kidney Dysfunction and Outcome After Stroke Thrombectomy |
title | Acute and Chronic Kidney Dysfunction and Outcome After Stroke Thrombectomy |
title_full | Acute and Chronic Kidney Dysfunction and Outcome After Stroke Thrombectomy |
title_fullStr | Acute and Chronic Kidney Dysfunction and Outcome After Stroke Thrombectomy |
title_full_unstemmed | Acute and Chronic Kidney Dysfunction and Outcome After Stroke Thrombectomy |
title_short | Acute and Chronic Kidney Dysfunction and Outcome After Stroke Thrombectomy |
title_sort | acute and chronic kidney dysfunction and outcome after stroke thrombectomy |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8421282/ https://www.ncbi.nlm.nih.gov/pubmed/33398648 http://dx.doi.org/10.1007/s12975-020-00881-2 |
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