Chronic kidney disease and intravenous thrombolysis in acute stroke: A systematic review and meta-analysis

Jin-Man Jung, Hyun Jung Kim, Hyeong Sik Ahn, Il Min Ahn, Youngrok Do, Jeong Yoon Choi, Woo Keun Seo, Kyungmi Oh, Kyung-Hee Cho, Sungwook Yu

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14 Citations (Scopus)

Abstract

Background The association between chronic kidney disease (CKD) and hemorrhagic complications or clinical outcomes in patients treated with intravenous (IV) thrombolytic agents is controversial. Methods We searched multiple databases for studies on the association between CKD and symptomatic intracerebral hemorrhage (ICH) and/or clinical outcomes in acute stroke patients treated with IV tissue plasminogen activator (tPA). Observational studies that evaluated the association between CKD and outcomes after adjusting for other confounding factors were eligible. We assessed study quality and performed a meta-analysis. The main outcome was symptomatic ICH. The secondary outcomes were poor functional status at 3 months using the modified Rankin Scale, mortality at 3 months, and any ICH. Results Seven studies were selected based on our eligibility criteria. Of 7168 patients treated with IV tPA, 2001 (27.9%) had CKD. Patients with CKD had a higher risk of symptomatic ICH and mortality [pooled odds ratio (OR) 1.56, 95% confidence interval (CI) 1.05-2.33 and pooled OR 1.70, 95% CI 1.03-2.81, respectively]. Patients with CKD were likely to have an increased risk of poor outcome at 3 months. There was no significant association between CKD and any ICH. Conclusions Chronic kidney disease may significantly affect symptomatic hemorrhagic complications and poor clinical outcomes following administration of IV tPA.

Original languageEnglish
Pages (from-to)345-350
Number of pages6
JournalJournal of the Neurological Sciences
Volume358
Issue number1-2
DOIs
Publication statusPublished - 2015 Mar 28

Keywords

  • Chronic kidney disease
  • Meta-analysis
  • Outcome
  • Stroke
  • Systematic review
  • Tissue-type plasminogen activator

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology

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    Jung, J-M., Kim, H. J., Ahn, H. S., Ahn, I. M., Do, Y., Choi, J. Y., Seo, W. K., Oh, K., Cho, K-H., & Yu, S. (2015). Chronic kidney disease and intravenous thrombolysis in acute stroke: A systematic review and meta-analysis. Journal of the Neurological Sciences, 358(1-2), 345-350. https://doi.org/10.1016/j.jns.2015.09.353