Prognostic Factors in Acute Ischemic Stroke With a Decreased Estimated Glomerular Filtration Rate

Introduction: Intra-arterial thrombectomy (IAT), which is widely used to treat acute ischemic stroke, occasionally results in adverse outcomes. IAT-associated risks in patients with decreased estimated glomerular filtration rate (eGFR) remain undefined. Therefore, this study aimed to investigate the effect of IAT on outcomes in patients with acute ischemic stroke and decreased eGFR and to explore other prognosis-associated factors. Methods: This study included 309 patients with acute ischemic stroke and decreased eGFR to compare demographics, risk factors, and clinical outcomes based on IAT status. Factors affecting outcomes were investigated, and multivariate logistic regression analysis was performed to identify important determinants. Results: In a cohort of 309 patients with acute ischemic stroke and decreased eGFR, the factors associated with good outcomes, defined as a 3-month modified Rankin Scale score of 0–2, included younger age, absence of IAT, and a higher eGFR. White matter hyperintensity, early neurological deterioration, and C-reactive protein levels, which were significant in the univariate analysis, were not significant in the multivariate model. Conclusion: In patients with acute ischemic stroke and decreased eGFR, IAT receipt was associated with poorer 3-month functional outcomes compared with no IAT. Older age and lower eGFR were independently associated with poorer prognosis, possibly reflecting increased vascular vulnerability and diminished neurorecovery capacity. Although IAT remains an important treatment option, these findings highlight the need for further research specific to AIS patients with decreased eGFR to support individualized clinical decision-making.