tetano
Editor, Senior Moderator
J Nephrol
. 2021 Jan 2.
doi: 10.1007/s40620-020-00918-7. Online ahead of print.
Severe acute kidney injury in critically ill COVID-19 patients
Gaston J Pi?eiro[SUP] 1 [/SUP], Alicia Molina-And?jar[SUP] 2 [/SUP], Evelyn Hermida[SUP] 2 [/SUP], Miquel Blasco[SUP] 2 [/SUP], Luis F Quintana[SUP] 2 [/SUP], Guido Mu?oz Rojas[SUP] 3 [/SUP], Jordi Mercadal[SUP] 3 [/SUP], Pedro Castro[SUP] 4 [/SUP], Elena Sandoval[SUP] 5 [/SUP], Rut Andrea[SUP] 6 [/SUP], Javier Fern?ndez[SUP] 7 [/SUP], Joan Ramon Badia[SUP] 8 [/SUP], Alex Soriano[SUP] 9 [/SUP], Esteban Poch[SUP] 2 [/SUP], Hospital Cl?nic Critical Care COVID-19 working group (CCCC)
Collaborators, Affiliations
Abstract
Background: Acute kidney injury (AKI) is frequent in Coronavirus Infection Disease 2019 (COVID-19) patients. Factors associated with AKI in COVID-19 intensive care unit (ICU) patients and their outcomes have not been previously explored.
Methods: Prospective observational study of COVID-19 patients admitted to the ICUs of the Hospital Cl?nic of Barcelona (Spain), from March 25th to April 21st, 2020, who developed AKI stage 2 or higher (AKIN classification). The primary goal was to describe the characteristics of moderate-severe AKI of COVID-19 patients in an ICU context. As a secondary goal, we aimed to find independent predictors of AKI progression, Renal Replacement Therapy (RRT) requirement and mortality among these patients.
Results: During the study period, 52 out of 237 ICU patients, developed AKIN stage 2 or higher and were included in the study. A Sequential Organ Failure Assessment (SOFA) score at AKI diagnosis of 8 or higher was associated with RRT, OR 5.2, p 0.032. At the time of AKI diagnosis, patients had a worse liver profile and higher inflammation markers than at admission. Fifty per cent of the patients presented AKI progression from AKIN 2 to 3 and 28.85% required RRT. The use of corticosteroids in 69.2% of patients was associated with a reduced requirement of RRT, OR 0.13 (CI 95% 0.02-0.89), p 0.037. AKI was associated with high mortality (50%) and a longer hospital stay, median 35 vs 18 days (p 0.024).
Conclusions: The prevalence of moderate/severe AKI in COVID-19 patients admitted to the ICU is high and has a strong correlation with mortality and length of hospital stay.
Keywords: Acute kidney injury; COVID-19; Intensive care; Renal replacement therapy.
. 2021 Jan 2.
doi: 10.1007/s40620-020-00918-7. Online ahead of print.
Severe acute kidney injury in critically ill COVID-19 patients
Gaston J Pi?eiro[SUP] 1 [/SUP], Alicia Molina-And?jar[SUP] 2 [/SUP], Evelyn Hermida[SUP] 2 [/SUP], Miquel Blasco[SUP] 2 [/SUP], Luis F Quintana[SUP] 2 [/SUP], Guido Mu?oz Rojas[SUP] 3 [/SUP], Jordi Mercadal[SUP] 3 [/SUP], Pedro Castro[SUP] 4 [/SUP], Elena Sandoval[SUP] 5 [/SUP], Rut Andrea[SUP] 6 [/SUP], Javier Fern?ndez[SUP] 7 [/SUP], Joan Ramon Badia[SUP] 8 [/SUP], Alex Soriano[SUP] 9 [/SUP], Esteban Poch[SUP] 2 [/SUP], Hospital Cl?nic Critical Care COVID-19 working group (CCCC)
Collaborators, Affiliations
- PMID: 33387345
- DOI: 10.1007/s40620-020-00918-7
Abstract
Background: Acute kidney injury (AKI) is frequent in Coronavirus Infection Disease 2019 (COVID-19) patients. Factors associated with AKI in COVID-19 intensive care unit (ICU) patients and their outcomes have not been previously explored.
Methods: Prospective observational study of COVID-19 patients admitted to the ICUs of the Hospital Cl?nic of Barcelona (Spain), from March 25th to April 21st, 2020, who developed AKI stage 2 or higher (AKIN classification). The primary goal was to describe the characteristics of moderate-severe AKI of COVID-19 patients in an ICU context. As a secondary goal, we aimed to find independent predictors of AKI progression, Renal Replacement Therapy (RRT) requirement and mortality among these patients.
Results: During the study period, 52 out of 237 ICU patients, developed AKIN stage 2 or higher and were included in the study. A Sequential Organ Failure Assessment (SOFA) score at AKI diagnosis of 8 or higher was associated with RRT, OR 5.2, p 0.032. At the time of AKI diagnosis, patients had a worse liver profile and higher inflammation markers than at admission. Fifty per cent of the patients presented AKI progression from AKIN 2 to 3 and 28.85% required RRT. The use of corticosteroids in 69.2% of patients was associated with a reduced requirement of RRT, OR 0.13 (CI 95% 0.02-0.89), p 0.037. AKI was associated with high mortality (50%) and a longer hospital stay, median 35 vs 18 days (p 0.024).
Conclusions: The prevalence of moderate/severe AKI in COVID-19 patients admitted to the ICU is high and has a strong correlation with mortality and length of hospital stay.
Keywords: Acute kidney injury; COVID-19; Intensive care; Renal replacement therapy.