Acute Kidney Injury and Renal Replacement Therapy in Critically Ill COVID-19 Patients: Risk Factors and Outcomes: A Single-Center Experience in Brazil
| Autor: | Marcelino de Souza Durão, Julio Cesar Martins Monte, Leonardo José Rolim Ferraz, Marcelo Costa Batista, Virgilio Gonçalves Pereira, Marisa Petrucelli Doher, Bento Fortunato Cardoso dos Santos, Oscar Fernando Pavão dos Santos, Thais Nemoto Matsui, Patricia Faria Scherer, Ary Serpa Neto, Bruno C. Silva, Adriano Luiz Ammirati, Fabiana D Carneiro, Rinaldo Bellomo, Fabricio Rodrigues Torres de Carvalho, Thiago Domingos Corrêa, Bruna Gomes Barbeiro |
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| Přispěvatelé: | Intensive Care Medicine |
| Rok vydání: | 2020 |
| Předmět: |
Male
Continuous renal replacement therapy medicine.medical_treatment 030232 urology & nephrology Comorbidity 030204 cardiovascular system & hematology urologic and male genital diseases law.invention 0302 clinical medicine Risk Factors law Severe acute respiratory syndrome coronavirus 2 Medicine Hospital Mortality Aged 80 and over Respiratory Distress Syndrome Acute kidney injury Hematology General Medicine Middle Aged Intensive care unit female genital diseases and pregnancy complications Renal Replacement Therapy Intensive Care Units C-Reactive Protein Treatment Outcome Nephrology Creatinine Female Brazil Research Article medicine.medical_specialty Critical Illness Multiple Organ Failure 03 medical and health sciences Internal medicine Humans Renal replacement therapy Renal Insufficiency Chronic Risk factor Dialysis Aged Retrospective Studies SARS-CoV-2 business.industry COVID-19 Retrospective cohort study medicine.disease Respiration Artificial business Multiple organ dysfunction syndrome |
| Zdroj: | Blood Purification Blood purification. S. Karger AG |
| ISSN: | 1421-9735 0253-5068 |
| Popis: | 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. |
| Databáze: | OpenAIRE |
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