Renal Function Impact on Ischemic Stroke Outcomes
Summary
Renal impairment, manifesting as reduced glomerular filtration rate or proteinuria, exerts a profound influence on the prognosis of patients with ischaemic stroke. Chronic kidney disease correlates with higher in-hospital mortality, diminished adherence to guideline-based therapies and poorer functional recovery. In the acute setting, emerging data highlight acute kidney injury as an independent predictor of unfavourable neurological outcomes and increased three-month mortality following both mechanical thrombectomy and intravenous thrombolysis. Beyond direct harm from renal dysfunction, concerns over contrast-induced nephropathy can affect the timing and selection of neuroimaging modalities, although evidence suggests the risk of lasting renal sequelae is low. Integrating renal assessment into stroke management pathways has the potential to refine risk stratification, optimise imaging strategies and guide therapeutic decisions, emphasising the need for a multidisciplinary approach to mitigate renal–brain interplay in ischaemic stroke care.
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Renal Function Impact on Ischemic Stroke Outcomes publication trend
The graph below shows the total number of articles in renal function impact on ischemic stroke outcomes across all publications each year (not limited to Nature Index journals).
Technical terms
Estimated glomerular filtration rate (eGFR): An index of kidney filtration function derived from serum creatinine, age and body size.
Acute kidney injury (AKI): Rapid deterioration in renal function, often defined by changes in serum creatinine or urine output.
Chronic kidney disease (CKD): Persistent reduction in eGFR or evidence of renal damage for over three months.
Mechanical thrombectomy: Endovascular procedure to remove thrombus from a cerebral artery in acute stroke.
Symptomatic intracranial haemorrhage (sICH): Clinically significant brain bleeding post-reperfusion intervention.
References
- Patterns of Care Quality and Prognosis Among Hospitalized Ischemic Stroke Patients With Chronic Kidney Disease. Journal of the American Heart Association (2014).
- Proteinuria Independently Predicts Unfavorable Outcome of Ischemic Stroke Patients Receiving Intravenous Thrombolysis. PLOS ONE (2013).
- The impact of acute kidney injury on in-hospital mortality in acute ischemic stroke patients undergoing intravenous thrombolysis. PLOS ONE (2017).
- Influence of renal function on stroke outcome after mechanical thrombectomy: a prospective cohort study. BMC Neurology (2020).
- Acute and Chronic Kidney Dysfunction and Outcome After Stroke Thrombectomy. Translational Stroke Research (2021).
- Acute Kidney Injury after Endovascular Treatment in Patients with Acute Ischemic Stroke. Journal of Clinical Medicine (2020).
- Renal Safety of CT Angiography and Perfusion Imaging in the Emergency Evaluation of Acute Stroke. American Journal of Neuroradiology (2008).
- The Risk of Acute Radiocontrast-Mediated Kidney Injury Following Endovascular Therapy for Acute Ischemic Stroke Is Low. American Journal of Neuroradiology (2010).
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