Intravenous Thrombolysis Improves the Prognosis of Patients with Acute Ischemic Stroke and Chronic Kidney Disease

Ding, Yuanhua; Liu, Yanping; Huang, Qing; Ma, Li; Tian, You‐Yong; Zhou, Junshan; Niu, Jingyang

doi:10.1016/j.jemermed.2022.05.013

Cited by 1 publication

(2 citation statements)

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“…They also underscore the necessity for comprehensive management strategies in acute settings that effectively address the unique challenges posed by CKD, aiming to optimize patient outcomes. Whilst our findings indicate that there is a significant association in CKD patients with reperfusion therapy, it is worth noting that the prognosis after acAIS in CKD patients is worse in those not treated with reperfusion therapy 35,36 …”

Section: Discussionmentioning

confidence: 70%

“…there is a significant association in CKD patients with reperfusion therapy, it is worth noting that the prognosis after acAIS in CKD patients is worse in those not treated with reperfusion therapy. 35,36 The first key finding revealed a significantly high prevalence of pre-existing CKD in patients with acAIS upon their arrival at the emergency department. 10 The prevalence of CKD appears to be more pronounced in patients who received IVT compared to those undergoing EVT.…”

Section: Discussionmentioning

confidence: 99%

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Chronic kidney disease prevalence and clinical outcomes in anterior circulation acute ischemic stroke patients with reperfusion therapy: A meta‐analysis

Rajesh,

Spring,

Beran

et al. 2023

Nephrology

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AimChronic Kidney Disease (CKD) is a common comorbidity among acute ischaemic stroke (AIS) patients undergoing reperfusion therapies, including intravenous thrombolysis (IVT) and endovascular thrombectomy (EVT). Acknowledging CKD's prevalence in this cohort and understanding its influence on outcomes is crucial for prognosis and optimizing care. This study aims to determine the prevalence of CKD among anterior circulation AIS (acAIS) patients undergoing reperfusion therapies and to analyse the role of CKD in mediating outcomes.MethodsA random‐effects meta‐analysis was conducted to pool and examine prevalence data. A total of 263 633 patients were included in the meta‐analysis. The study assessed CKD's association with functional outcomes, symptomatic intracranial haemorrhage (sICH) and mortality.ResultsThe overall pooled prevalence of CKD among acAIS ranged from 30% to 56% in IVT‐treated patients and 16%–42% for EVT‐treated patients. CKD was associated with increased odds of unfavourable functional outcome at 90 days in both IVT (OR 1.837; 95% CI: [1.599; 2.110]; p < .001) and EVT (OR 1.804; 95% CI: [1.525; 2.133]; p < .001) groups. In IVT‐treated patients, CKD was associated with increased odds of 30‐day mortality (OR 6.211; 95% CI: [1.105; 34.909]; p = .038). CKD in IVT‐treated patients exhibited increased odds of sICH, albeit statistically non‐significant (OR 1.595; 95% CI: [0.567; 3.275]).ConclusionsThe high prevalence of CKD and its significant impact on outcomes in acAIS patients treated with reperfusion therapies underscore its clinical significance. This insight can guide personalised care strategies and potentially improve the prognosis in the management of acAIS.image

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Section: Discussionmentioning

confidence: 70%