Incidence, risk factors and outcome of acute kidney injury in critically ill COVID-19 patients in Tyrol, Austria: a prospective multicenter registry study.

Autor: Mayerhöfer T; Division of Intensive Care and Emergency Medicine, Department of Internal Medicine, Medical University Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria., Perschinka F; Division of Intensive Care and Emergency Medicine, Department of Internal Medicine, Medical University Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria., Klein SJ; Division of Intensive Care and Emergency Medicine, Department of Internal Medicine, Medical University Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria.; Internal Medicine II, Gastroenterology, Hepatology and Rheumatology, Karl Landsteiner University of Health Sciences, University Hospital St. Pölten, St. Pölten, Austria., Peer A; Division of Intensive Care and Emergency Medicine, Department of Internal Medicine, Medical University Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria., Lehner GF; Division of Intensive Care and Emergency Medicine, Department of Internal Medicine, Medical University Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria., Bellmann R; Division of Intensive Care and Emergency Medicine, Department of Internal Medicine, Medical University Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria., Gasteiger L; Department of Anesthesia and Critical Care Medicine, Medical University Innsbruck, Innsbruck, Austria., Mittermayr M; Department of Anesthesia and Critical Care Medicine, Medical University Innsbruck, Innsbruck, Austria., Breitkopf R; Department of Anesthesia and Critical Care Medicine, Medical University Innsbruck, Innsbruck, Austria., Eschertzhuber S; Department of Anesthesia and Intensive Care Medicine, Hospital Hall, Hall, Austria., Mathis S; Department of General and Surgical Intensive Care Medicine, Medical University Innsbruck, Innsbruck, Austria., Fiala A; Department of General and Surgical Intensive Care Medicine, Medical University Innsbruck, Innsbruck, Austria., Fries D; Department of General and Surgical Intensive Care Medicine, Medical University Innsbruck, Innsbruck, Austria., Ströhle M; Department of Anesthesia and Intensive Care Medicine, Hospital Kufstein, Kufstein, Austria., Foidl E; Department of Anesthesia and Intensive Care Medicine, Hospital Kufstein, Kufstein, Austria., Hasibeder W; Department of Anesthesiology and Critical Care Medicine, Hospital St. Vinzenz Zams, Zams, Austria., Helbok R; Department of Neurology, Medical University Innsbruck, Innsbruck, Austria.; Department of Neurology, Johannes Kepler University Linz, Linz, Austria., Kirchmair L; Department of Anesthesia and Critical Care Medicine, Hospital Schwaz, Schwaz, Austria., Stögermüller B; Department of Anesthesia and Critical Care Medicine, Hospital Schwaz, Schwaz, Austria., Krismer C; Department of Internal Medicine, Hospital St. Vinzenz Zams, Zams, Austria., Heiner T; Department of Anesthesia and Intensive Care Medicine, Hospital Reutte, Reutte, Austria., Ladner E; Department of Anesthesia and Intensive Care Medicine, Hospital Reutte, Reutte, Austria., Thomé C; Department of Neurosurgery, Medical University Innsbruck, Innsbruck, Austria., Preuß-Hernandez C; Department of Neurosurgery, Medical University Innsbruck, Innsbruck, Austria., Mayr A; Department of Anesthesia and Intensive Care Medicine, Hospital Lienz, Lienz, Austria., Potocnik M; Department of Anesthesia and Intensive Care Medicine, Hospital St. Johann in Tyrol, St. Johann in Tyrol, Austria., Reitter B; Department of Anesthesia and Intensive Care Medicine, Hospital St. Johann in Tyrol, St. Johann in Tyrol, Austria., Brunner J; Department of Pediatrics, Medical University Innsbruck, Innsbruck, Austria.; Faculty of Medicine and Dentistry, Danube Private University, Krems, Austria., Zagitzer-Hofer S; Department of Internal Medicine, Hospital Hall, Hall, Austria., Ribitsch A; Department of Internal Medicine, Hospital Lienz, Lienz, Austria., Joannidis M; Division of Intensive Care and Emergency Medicine, Department of Internal Medicine, Medical University Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria. michael.joannidis@i-med.ac.at.
Jazyk: angličtina
Zdroj: Journal of nephrology [J Nephrol] 2023 Dec; Vol. 36 (9), pp. 2531-2540. Date of Electronic Publication: 2023 Oct 14.
DOI: 10.1007/s40620-023-01760-3
Abstrakt: Introduction: Acute kidney injury is a frequent complication in critically ill patients with and without COVID-19. The aim of this study was to evaluate the incidence of, and risk factors for, acute kidney injury and its effect on clinical outcomes of critically ill COVID-19 patients in Tyrol, Austria.
Methods: This multicenter prospective registry study included adult patients with a SARS-CoV-2 infection confirmed by polymerase chain reaction, who were treated in one of the 12 dedicated intensive care units during the COVID-19 pandemic from February 2020 until May 2022.
Results: In total, 1042 patients were included during the study period. The median age of the overall cohort was 66 years. Of the included patients, 267 (26%) developed acute kidney injury during their intensive care unit stay. In total, 12.3% (n = 126) required renal replacement therapy with a median duration of 9 (IQR 3-18) days. In patients with acute kidney injury the rate of invasive mechanical ventilation was significantly higher with 85% (n = 227) compared to 41% (n = 312) in the no acute kidney injury group (p < 0.001). The most important risk factors for acute kidney injury were invasive mechanical ventilation (OR = 4.19, p < 0.001), vasopressor use (OR = 3.17, p < 0.001) and chronic kidney disease (OR = 2.30, p < 0.001) in a multivariable logistic regression analysis. Hospital and intensive care unit mortality were significantly higher in patients with acute kidney injury compared to patients without acute kidney injury (Hospital mortality: 52.1% vs. 17.2%, p < 0.001, ICU-mortality: 47.2% vs. 14.7%, p < 0.001).
Conclusion: As in non-COVID-19 patients, acute kidney injury is clearly associated with increased mortality in critically ill COVID-19 patients. Among known risk factors, invasive mechanical ventilation has been identified as an independent and strong predictor of acute kidney injury.
(© 2023. The Author(s).)
Databáze: MEDLINE
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