Renal impairment and the prognosis of endovascular thrombectomy: a meta-analysis and systematic review.

BACKGROUND

The association between renal impairment (RI) and stroke outcome after endovascular thrombectomy (EVT) remains unclear, which limits the estimation of patient prognosis by clinicians involved in EVT decision-making.

PURPOSE

This study aimed to investigate the association between RI and acute ischemic stroke (AIS) outcomes in patients treated with EVT.

METHODS

Studies involving the association between RI at admission and AIS outcomes after EVT were retrieved from the PubMed and Embase databases from their inception to 17 January 2022. A fixed-effects model was used to synthesize the data of the included studies. Sensitivity analysis was performed to identify the source of heterogeneity.

RESULTS

Overall, 11 studies, including 5053 patients with stroke receiving EVT, were included in the full analysis. In unadjusted analyses, RI was associated with 3-month poor functional outcome and mortality; the odds ratios (ORs) were 2.13 [10 studies; 95% confidence interval (CI), 1.77-2.56;  = 45%] and 2.42 (8 studies; 95% CI, 2.02-2.90;  = 58%), respectively. In adjusted analyses, the above associations remained significant; the OR of the 3-month poor functional outcome was 1.49 (5 studies; 95% CI, 1.17-1.90;  = 58%), and the OR of the 3-month mortality was 1.84 (6 studies; 95% CI, 1.45-2.33;  = 74%). Similar results were obtained in sensitivity analyses.

CONCLUSION

Our results suggest that in patients with AIS who underwent EVT, RI at admission was associated with 3-month poor functional outcome and mortality.