Data from: Intravenous thrombolysis in patients with chronic kidney disease: A systematic review and meta-analysis

<p><b><span>Objective</span></b><span> We sought to determine the association of chronic kidney disease (CKD) with the safety and efficacy of intravenous thrombolysis (IVT) among acute ischemic stroke (AIS) patients.</span></p> <p><b><span>Methods</span></b><span> Systematic review and pairwise meta-analysis of studies involving patients with CKD undergoing IVT for AIS were conducted to evaluate the following outcomes: symptomatic intracranial hemorrhage (sICH), asymptomatic and any ICH, in-hospital and 3-month mortality, </span>3-month favorable functional outcome (FFO, mRS 0-1) and <span>3-month functional independence (FI, mRS 0-2). CKD was defined using estimated glomerular filtration rate (eGFR) ranging from mild (eGFR: 60-89ml/min), moderate (eGFR: 30-59ml/min) and severe (eGFR: 15-29ml/min). </span></p> <p><b><span>Results</span></b><span> We identified 20 studies comprising </span>60,486 AIS <span>patients treated with IVT. In unadjusted analyses, CKD was associated with </span>sICH according to NINDS (7 studies; OR=1.41, 95%CI: 1.19–1.67) and ECASS-II (9 studies; OR=1.37, 95%CI: 1.01–1.85) definitions, any ICH (8 studies; OR=1.42, 95%CI: 1.18–1.70), 3-month mortality (9 studies; OR = 2.20, 95%CI: 1.72–2.81)<span>, </span>3-month FFO (8 studies; OR=0.58, 95%CI: 0.47–0.72) and <span>3-month FI</span> (8 studies; OR=0.57, 95%CI: 0.46–0.71). In adjusted analyses, <span>CKD</span> was associated with sICH according to NINDS (4 studies; OR_adj=1.34, 95%CI: 1.01–1.79) and ECASS-II (3 studies; OR_adj=2.08, 95%CI 1.27–3.43) definitions, any ICH (6 studies; OR_adj=1.41, 95%CI 1.01–1.97), in-hospital mortality (2 studies; OR_adj =1.19; 95%CI, 1.09-1.30) and 3-month FFO (6 studies; OR_adj=0.80, 95%CI 0.70–0.92).  </p> <p><b><span>Conclusions</span></b><span> After adjustment for confounders in this pairwise meta-analysis, moderate-severe CKD is associated with increased risks of intracranial hemorrhage and worse functional outcomes among AIS patients treated with IVT. </span></p>