Contrast-Associated Acute Kidney Injury After Endovascular Therapy for Acute Ischemic Stroke: A Meta-Analysis.

Background: This study aimed to investigate the incidence of contrast-associated acute kidney injury (CA-AKI) and renal replacement therapy (RRT) after endovascular therapy (EVT) for acute ischemic stroke. Methods: PubMed, the Cochrane Library, and the Web of Science were searched to identify all relevant studies regarding the incidence of CA-AKI and RRT in patients with acute ischemic stroke receiving EVT until July 2021. To pool the incidence of CA-AKI and RRT, a random-effects model with a double arcsine transformation was used. Subgroup analysis and meta-regression analysis were used to investigate the relationship of individual study-level covariates with CA-AKI and RRT. Results: It was found that 15 studies involving 27 246 patients with acute ischemic stroke receiving EVT met the inclusion criteria. The incidence of CA-AKI was 5.0% (95% CI, 2.1%-8.9%), and the incidence of RRT was 0.2% (95% CI, 0.0%-0.4%). Subgroup analysis showed that the incidence of CA-AKI was higher when using the European Society of Urogenital Radiology's criteria (6.6%, 95% CI, 3.8%-10.1%) than when using the Kidney Disease: The Improving Global Outcomes criteria (3.0%, 95% CI, 1.0%-6.1%). Meta-regression analysis confirmed that the presence of diabetes was associated with increased rates of CA-AKI ( Conclusions: The risk of CA-AKI and RRT secondary to EVT is low for patients with acute ischemic stroke; therefore, treatment should not be delayed for the patients eligible for EVT by waiting for the results of renal function analysis.