Evaluation of Clinical Characteristics of Critically Ill COVID-19 Patients With Renal Failure.

Autor:	Yavuz T; Intensive Care Unit, Tepecik Training and Research Hospital, Health Sciences University, Izmir, TUR., Sarac O; Anesthesiology and Critical Care, Izmir Bayraklı City Hospital, Izmir, TUR., Yeniay H; Anesthesiology and Critical Care, Izmir Bayraklı City Hospital, Izmir, TUR., Nadir Y; Infectious Disease, Tepecik Training and Research Hospital, Health Sciences University, Izmir, TUR., Alpdogan O; Anesthesiology and Critical Care, Izmir Bayraklı City Hospital, Izmir, TUR.
Jazyk:	angličtina
Zdroj:	Cureus [Cureus] 2024 Jun 13; Vol. 16 (6), pp. e62297. Date of Electronic Publication: 2024 Jun 13 (Print Publication: 2024).
DOI:	10.7759/cureus.62297
Abstrakt:	Introduction: This study aimed to investigate the clinical characteristics and prognostic factors of critically ill COVID-19 patients with renal failure admitted to the ICU. Methods: We analyzed 300 adult patients with SARS-CoV-2 infection admitted to the ICU between November 1, 2020, and June 1, 2022. Demographic data, renal function parameters, and outcomes were collected and analyzed. Results: The median age was 72 years, and 54.3% were men. Mechanical ventilation was required for 86.3% of patients, with 71.0% needing invasive ventilation. Renal failure was present in 43.3% of patients at ICU admission, significantly associated with older age, higher mechanical and invasive ventilation needs, and increased ICU mortality (76.9% vs. 51.8%, p<0.001). Patients with renal failure had elevated levels of urea, creatinine, C-reactive protein (CRP), D-dimer, white blood cell (WBC), neutrophil (Neu), and procalcitonin (PCT) (p<0.001 for all). Among patients with acute kidney injury (AKI), those with AKI had significantly higher median age (75 vs. 66 years, p<0.001), mechanical ventilation requirement (93.6% vs. 74.3%, p<0.001) and ICU mortality (79.1% vs. 35.4%, p<0.001). Elevated levels of urea (76 vs. 44 mg/dL, p<0.001) and creatinine (1.4 vs. 0.8 mg/dL, p<0.001), as well as inflammatory markers CRP and D-dimer (p=0.001), were observed in AKI patients. Survivors had lower median age (66.0 vs. 74.0 years, p<0.001) and lower prevalence of chronic kidney disease (CKD) (4.5% vs. 12.8, p=0.019) and AKI (34.8% vs. 78.7%, p<0.001). Non-survivors exhibited higher levels of urea, creatinine, lactate dehydrogenase (LDH), CRP, ferritin, and D-dimer (p<0.001 for all). Conclusion: Renal failure and AKI are prevalent in critically ill COVID-19 patients and are associated with worse outcomes. Elevated creatinine and urea levels at ICU admission are significant predictors of ICU mortality, underscoring the importance of early recognition and management of renal impairment in these patients. Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Local Institutional Ethics Committee issued approval 2022/12-03. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work. (Copyright © 2024, Yavuz et al.)
Databáze:	MEDLINE
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