De Rubeis Gianluca, Alessiani Michele, Fabiano Sebastiano, Bertaccini Luca, Wlderk Andrea, Pezzella Francesca Romana, Anticoli Sabrina, Barber Peter Alan, Saba Luca, Pampana Enrico
Department of Diagnostic, UOC of Diagnostic and Interventional Neuroradiology, San Camillo-Forlanini Hospital, Italy.
Department of Neurology, "S. M.Goretti" Hospital, Italy.
Neuroradiol J. 2025 Apr;38(2):185-191. doi: 10.1177/19714009241303134. Epub 2024 Nov 21.
AimTo investigate the prognostic implication (mortality at 3 months) of acute kidney injury (AKI) in acute ischemic stroke treated with mechanical thrombectomy (MT).Material and MethodsA literature search was performed using PubMed/OVID/Cochran's CENTRAL database (time frame: inception to January 2023). Study characteristics, patient status, clinical outcomes, AKI incidence, and sample size were recorded. The exclusion criteria were non-English literature, no human subjects, and <10 patients as the sample size. Studies were assessed using the MINORS/GRADE system. Meta-analysis and meta-regression with a random-effects model were performed.Results3314 studies were retrieved. After applying the exclusion criteria, the final population included of 18/3314 studies (0.5%). Among them, only 6/18 (33.3%) studies reported results in two separate groups (AKI vs non-AKI), allowing for inference statistics for a total population of 3229 (538.6 ± 403.7). The I^2 was 34.6 and Q's Cochrane was 7.80. The pooled odds ratio (OR) for mortality at 3 months in patients with AKI was 5.8 (95% confidence interval [95% CI] 95% CI 3.62 to 9.52). Leave-one-out meta-analysis showed no significant sources of heterogeneity. In the meta-regression, diabetes prevalence was associated with a higher mortality rate (OR 1.14, 95% CI 1.03 to 1.28), and lower age and a small amount of contrast media were negatively correlated (0.91 [95% CI 0.83 to 0.99] and OR 0.97 [95% CI 0.94 to 1.00], respectively).ConclusionAKI was significantly associated with the mortality rate in MT-treated stroke patients (OR 5.8 [95% CI 3.62 to 9.36]).
探讨机械取栓术（MT）治疗急性缺血性卒中时急性肾损伤（AKI）的预后意义（3个月时的死亡率）。
使用PubMed/OVID/Cochrane中心数据库进行文献检索（时间范围：创刊至2023年1月）。记录研究特征、患者状态、临床结局、AKI发病率和样本量。排除标准为非英文文献、无人类受试者以及样本量<10例患者。使用MINORS/GRADE系统对研究进行评估。采用随机效应模型进行荟萃分析和荟萃回归。
检索到3314项研究。应用排除标准后，最终纳入18/3314项研究（0.5%）。其中，只有6/18（33.3%）项研究报告了两个独立组（AKI与非AKI）的结果，可对总共3229例（538.6±403.7）进行推断统计。I^2为34.6，Q的Cochrane值为7.80。AKI患者3个月时死亡的合并比值比（OR）为5.8（95%置信区间[95%CI]95%CI 3.62至9.52）。逐一剔除荟萃分析显示无显著异质性来源。在荟萃回归中，糖尿病患病率与较高死亡率相关（OR 1.14，95%CI 1.03至1.28），年龄较小和造影剂用量较少呈负相关（分别为0.91[95%CI 0.83至0.99]和OR 0.97[95%CI 0.94至1.00]）。
AKI与MT治疗的卒中患者死亡率显著相关（OR 5.8[95%CI 3.62至9.36]）。
