tetano
Editor, Senior Moderator
PLoS One
. 2024 Oct 24;19(10):e0309655.
doi: 10.1371/journal.pone.0309655. eCollection 2024. Kidney replacement therapy in COVID-19-Related acute kidney injury: The impact of timing on mortality
Carlos Augusto Pereira de Almeida[SUP] 1 [/SUP], Marcia Fernanda Arantes de Oliveira[SUP] 1 [/SUP], Alexandre Macedo Teixeira[SUP] 1 [/SUP], Carla Paulina Sandoval Cabrera[SUP] 1 [/SUP], Igor Smolentzov[SUP] 1 [/SUP], Bernardo Vergara Reichert[SUP] 1 [/SUP], Paulo Ricardo Gessolo Lins[SUP] 1 [/SUP], Camila Eleuterio Rodrigues[SUP] 1 [/SUP], Victor Faria Seabra[SUP] 1 [/SUP], Lucia Andrade[SUP] 1 [/SUP]
Affiliations
The objective of this study was to determine the impact of the timing of KRT, dichotomized by a temporal criterion or by creatinine level, in patients with COVID-19-related AKI. This was a retrospective study involving 512 adult patients admitted to the ICU. All participants had laboratory-confirmed COVID-19 and a confirmed diagnosis of AKI. The potential predictors were the determination of the timing of KRT based on a temporal criterion (days since hospital admission) and that based on a serum creatinine cutoff criterion. Covariates included age, sex, and the SOFA score, as well as the need for mechanical ventilation and vasopressors. The main outcome measure was in-hospital mortality. We evaluated 512 patients, of whom 69.1% were men. The median age was 64 years. Of the 512 patients, 76.6% required dialysis after admission. The overall in-hospital mortality rate was 72.5%. When the timing of KRT was determined by the temporal criterion, the risk of in-hospital mortality was significantly higher for later KRT than for earlier KRT-84% higher in the univariate analysis (OR = 1.84, 95%, [CI]: 1.10-3.09) and 140% higher after adjustment for age, sex, and SOFA score (OR = 2.40, 95% CI: 1.36-4.24). When it was determined by the creatinine cutoff criterion, there was no such difference between high and low creatinine at KRT initiation. In patients with COVID-19-related AKI, earlier KRT might be associated with lower in-hospital mortality.
. 2024 Oct 24;19(10):e0309655.
doi: 10.1371/journal.pone.0309655. eCollection 2024. Kidney replacement therapy in COVID-19-Related acute kidney injury: The impact of timing on mortality
Carlos Augusto Pereira de Almeida[SUP] 1 [/SUP], Marcia Fernanda Arantes de Oliveira[SUP] 1 [/SUP], Alexandre Macedo Teixeira[SUP] 1 [/SUP], Carla Paulina Sandoval Cabrera[SUP] 1 [/SUP], Igor Smolentzov[SUP] 1 [/SUP], Bernardo Vergara Reichert[SUP] 1 [/SUP], Paulo Ricardo Gessolo Lins[SUP] 1 [/SUP], Camila Eleuterio Rodrigues[SUP] 1 [/SUP], Victor Faria Seabra[SUP] 1 [/SUP], Lucia Andrade[SUP] 1 [/SUP]
Affiliations
- PMID: 39446912
- DOI: 10.1371/journal.pone.0309655
The objective of this study was to determine the impact of the timing of KRT, dichotomized by a temporal criterion or by creatinine level, in patients with COVID-19-related AKI. This was a retrospective study involving 512 adult patients admitted to the ICU. All participants had laboratory-confirmed COVID-19 and a confirmed diagnosis of AKI. The potential predictors were the determination of the timing of KRT based on a temporal criterion (days since hospital admission) and that based on a serum creatinine cutoff criterion. Covariates included age, sex, and the SOFA score, as well as the need for mechanical ventilation and vasopressors. The main outcome measure was in-hospital mortality. We evaluated 512 patients, of whom 69.1% were men. The median age was 64 years. Of the 512 patients, 76.6% required dialysis after admission. The overall in-hospital mortality rate was 72.5%. When the timing of KRT was determined by the temporal criterion, the risk of in-hospital mortality was significantly higher for later KRT than for earlier KRT-84% higher in the univariate analysis (OR = 1.84, 95%, [CI]: 1.10-3.09) and 140% higher after adjustment for age, sex, and SOFA score (OR = 2.40, 95% CI: 1.36-4.24). When it was determined by the creatinine cutoff criterion, there was no such difference between high and low creatinine at KRT initiation. In patients with COVID-19-related AKI, earlier KRT might be associated with lower in-hospital mortality.