Acute Kidney Injury after Endovascular Treatment in Patients with Acute Ischemic Stroke

Acute kidney injury (AKI) is often associated with the use of contrast agents. We evaluated the frequency of AKI, factors associated with AKI after endovascular treatment (EVT), and associations with AKI and clinical outcomes. We retrospectively analyzed consecutively enrolled patients with acute ischemic stroke who underwent EVT at three stroke centers in Korea. We compared the characteristics of patients with and without AKI and independent factors associated with AKI after EVT. We also investigated the effects of AKI on functional outcomes and mortality at 3 months. Of the 601 patients analyzed, 59 patients (9.8%) developed AKI and five patients (0.8%) started renal replacement therapy after EVT. In the multivariate analysis, diabetes mellitus (odds ratio (OR), 2.341
95% CI, 1.283&ndash
4.269
p = 0.005), the contrast agent dose (OR, 1.107 per 10 mL
95% CI, 1.032&ndash
1.187
p = 0.004), and unsuccessful reperfusion (OR, 1.909
95% CI, 1.019&ndash
3.520
p = 0.040) were independently associated with AKI. The presence of AKI was associated with a poor functional outcome (OR, 5.145
95% CI, 2.177&ndash
13.850
p &lt
0.001) and mortality (OR, 8.164
95% CI, 4.046&ndash
16.709
0.001) at 3 months. AKI may also affect the outcomes of ischemic stroke patients undergoing EVT. When implementing EVT, practitioners should be aware of these risk factors.