Renal function evolution in stroke patients who received endovascular therapy

Abstract

INTRODUCTION: Concerning acute ischemic stroke, endovascular therapy for large cerebral vessel occlusion raises concerns about additional exposure to radioconstrat. We aimed to characterize kidney function evolution in order to identify contrast-induced nephropathy and also to study the impact of pre-existing kidney disease.
METHODS: We retrospectively studied the admissions to the Cerebrovascular Diseases Unit of Hospital Central do Funchal between March 2017 and February 2020 of those submitted to endovascular therapy. We obtained demographic and semiological characteristics. We measured plasmatic creatinine in three moments. We determined as outcomes: contrast-induced nephropathy, neurofunctional indexes and in-hospital death. We compared those with estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73 m2 with the rest.
RESULTS: Our sample of 62 cases (32 men [51.6%], age 69.6 ± 10.9 [mean ± standard deviation] years, National Institutes of Health Stroke Scale [NIHSS] at admission 15.0 ± 5.9), the plasmatic creatinine values were: admission 0.98 ± 0.23; 48 hours 0.86 ± 0,21; 5-7th day 0.87 ± 0.22 mg/dL. None met contrast-induced nephropathy criteria. Those with eGFR < 60 mL/min/1.73 m2 (16 cases, 25.8%) did not differ in nephrologic evolution (plasmatic creatinine variation at 48 hours: -0.17 ± 0.13 versus -0.11 ± 0.11 p=0.067) or neurological (modified Rankin Scale ? 2: 31.3% versus 23.9% p=0.563; ? NIHSS: -0.94 ± 9.6 versus -2.9 ± 9.0 p=0.479; mortality: 18.8% versus 19.6% p=0.943).
CONCLUSION: In this sample, kidney function evolution was favorable and without contrast-induced nephropathy cases. Those with eGFR < 60 mL/min/1.73 m2 pre-procedure did not show a worse outcome.