Ontology highlight
ABSTRACT: Background
Critically ill patients with COVID-19 may develop multiple organ dysfunction syndrome, including acute kidney injury (AKI). We report the incidence, risk factors, associations, and outcomes of AKI and renal replacement therapy (RRT) in critically ill COVID-19 patients.Methods
We performed a retrospective cohort study of adult patients with COVID-19 diagnosis admitted to the intensive care unit (ICU) between March 2020 and May 2020. Multivariable logistic regression analysis was applied to identify risk factors for the development of AKI and use of RRT. The primary outcome was 60-day mortality after ICU admission.Results
101 (50.2%) patients developed AKI (72% on the first day of invasive mechanical ventilation [IMV]), and thirty-four (17%) required RRT. Risk factors for AKI included higher baseline Cr (OR 2.50 [1.33-4.69], p = 0.005), diuretic use (OR 4.14 [1.27-13.49], p = 0.019), and IMV (OR 7.60 [1.37-42.05], p = 0.020). A higher C-reactive protein level was an additional risk factor for RRT (OR 2.12 [1.16-4.33], p = 0.023). Overall 60-day mortality was 14.4% {23.8% (n = 24) in the AKI group versus 5% (n = 5) in the non-AKI group (HR 2.79 [1.04-7.49], p = 0.040); and 35.3% (n = 12) in the RRT group versus 10.2% (n = 17) in the non-RRT group, respectively (HR 2.21 [1.01-4.85], p = 0.047)}.Conclusions
AKI was common among critically ill COVID-19 patients and occurred early in association with IMV. One in 6 AKI patients received RRT and 1 in 3 patients treated with RRT died in hospital. These findings provide important prognostic information for clinicians caring for these patients.
SUBMITTER: Doher MP
PROVIDER: S-EPMC7801990 | biostudies-literature | 2020 Dec
REPOSITORIES: biostudies-literature
Doher Marisa Petrucelli MP Torres de Carvalho Fabrício Rodrigues FR Scherer Patrícia Faria PF Matsui Thaís Nemoto TN Ammirati Adriano Luiz AL Caldin da Silva Bruno B Barbeiro Bruna Gomes BG Carneiro Fabiana Dias FD Corrêa Thiago Domingos TD Ferraz Leonardo José Rolim LJR Dos Santos Bento Fortunato Cardoso BFC Pereira Virgílio Gonçalves VG Batista Marcelo Costa MC Monte Júlio Cesar Martins JCM Santos Oscar Fernando Pavão OFP Bellomo Rinaldo R Serpa Neto Ary A Durão Marcelino de Souza MS
Blood purification 20201218 4-5
<h4>Background</h4>Critically ill patients with COVID-19 may develop multiple organ dysfunction syndrome, including acute kidney injury (AKI). We report the incidence, risk factors, associations, and outcomes of AKI and renal replacement therapy (RRT) in critically ill COVID-19 patients.<h4>Methods</h4>We performed a retrospective cohort study of adult patients with COVID-19 diagnosis admitted to the intensive care unit (ICU) between March 2020 and May 2020. Multivariable logistic regression ana ...[more]