Impact of renal impairment on outcomes of intracerebral hemorrhage: a systematic review and meta-analysis.

BACKGROUND: Chronic kidney disease (CKD) is linked to a number of cardiovascular complications, including intracerebral hemorrhage (ICH). However, the potential association between CKD and the outcomes of ICH are still inconclusive. This review aimed to clarify the relationship between CKD and ICH outcomes, such as mortality, functional disability, and length of hospitalization. METHODS: A comprehensive literature search was done in MEDLINE, Scopus, and Cochrane Central Register of Controlled Trials (CENTRAL), Google Scholar, EMBASE databases from inception until November 2023. Observational studies examining adult ICH patients with CKD were included. Risk of bias was evaluated using Newcastle-Ottawa Scale, and data synthesis was performed by random-effects meta-analysis. RESULTS: Twenty studies were included, encompassing a broad range of CKD and ICH patients. The meta-analysis demonstrated a significant association between CKD and adverse ICH outcomes. CKD patients had significantly higher mortality rates (pooled OR = 2.21; 95%CI 1.88-2.59; I2 = 98.7%) and functional disability (pooled OR = 1.51; 95%CI 1.30-1.75; I2 = 97.2%). CKD also showed potential associations with increased duration of hospital stay, though this outcome was less consistently reported. CONCLUSION: Our findings showed that CKD was linked to higher rates of mortality, and functional disability in patients with ICH, and was associated with extended hospitalization. Our results underscore the need for a comprehensive, multidisciplinary approach to managing this complex patient population. Further research should elucidate the underlying mechanisms of this association and inform strategies for improving patient outcomes. The integration of nephrological and neurological care may significantly benefit the management and prognosis of ICH in patients with CKD.