eISSN: 1897-4295
ISSN: 1734-9338
Advances in Interventional Cardiology/Postępy w Kardiologii Interwencyjnej
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1/2024
vol. 20
 
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abstract:
Original paper

Risk factors of acute kidney injury during hospitalization in acute ischaemic stroke patients undergoing mechanical thrombectomy

Paweł Wrona
1
,
Katarzyna Sawczyńska
1
,
Dominik Wróbel
2
,
Kaja Zdrojewska
2
,
Mateusz Giełczyński
2
,
Paweł Mizera
2
,
Paweł Brzegowy
3
,
Tadeusz Popiela
3
,
Agnieszka Słowik
1
,
Marcin Krzanowski
4

  1. Department of Neurology, Jagiellonian University Medical College, Krakow, Poland
  2. Student Scientific Group in Cerebrovascular Diseases, Jagiellonian University Medical College, Krakow, Poland
  3. Department of Radiology, Jagiellonian University Medical College, Krakow, Poland
  4. Department of Nephrology and Dialysis, Jagiellonian University Medical College, Krakow, Poland
Adv Interv Cardiol 2024; 20, 1 (75): 89–94
DOI: https://doi.org/10.5114/aic.2024.136374
Online publish date: 2024/03/15
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Introduction:
Acute kidney injury (AKI) seems to worsen the prognosis of acute ischaemic stroke (AIS) patients treated with mechanical thrombectomy (MT). At the same time, the procedure of MT increases AKI risk by iodinated contrast use. Identification of factors predisposing to AKI after MT is important for recognizing vulnerable patients and successful prevention.

Aim:
To identify factors associated with the occurrence of AKI during hospitalization in MT-treated AIS patients.

Material and methods:
The study included all AIS patients treated with MT in the University Hospital in Krakow from 2019 to 2021. The diagnosis of AKI during hospitalisation was based on serum creatinine concentration levels, according to the Kidney Disease Improving Global Outcomes guidelines. We compared patients with and without AKI in terms of age, sex, comorbidities, stroke course and laboratory test results at admission. We identified factors associated with the occurrence of AKI using univariate logistic regression analysis, with significant variables subsequently added to the multivariate analyses.

Results:
Among 593 MT-treated AIS patients the incidence of AKI during hospitalisation was 12.6%. AKI development was associated with diabetes, chronic kidney disease, total volume of iodinated contrast obtained during hospitalisation, posterior circulation stroke, lack of intravenous thrombolysis, and laboratory test results at admission: haemoglobin, glucose, urea, potassium, and creatinine. Total contrast volume and urea level were the most important independent risk factors associated with occurrence of AKI.

Conclusions:
AKI is common in MT-treated AIS patients. There is a need to establish a protocol for decreasing the risk of AKI in AIS patients undergoing MT and, in case it occurs, a procedure for its treatment.

keywords:

acute kidney injury, ischaemic stroke, mechanical thrombectomy, endovascular stroke treatment
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