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Title: Acute Kidney Injury and Renal Replacement Therapy in Critically Ill COVID-19 Patients: Risk Factors and Outcomes: A Single-Center Experience in Brazil.
Austin Authors: Doher, Marisa Petrucelli;Torres de Carvalho, Fabrício Rodrigues;Scherer, Patrícia Faria;Matsui, Thaís Nemoto;Ammirati, Adriano Luiz;Caldin da Silva, Bruno;Barbeiro, Bruna Gomes;Carneiro, Fabiana Dias;Corrêa, Thiago Domingos;Ferraz, Leonardo José Rolim;Dos Santos, Bento Fortunato Cardoso;Pereira, Virgílio Gonçalves;Batista, Marcelo Costa;Monte, Júlio Cesar Martins;Santos, Oscar Fernando Pavão;Bellomo, Rinaldo ;Serpa Neto, Ary ;Durão, Marcelino de Souza
Affiliation: Nephrology Division, Hospital Israelita Albert Einstein, São Paulo, Brazil
Department of Critical Care Medicine, Hospital Israelita Albert Einstein, São Paulo, Brazil
Nephrology Division, Escola Paulista de Medicina, Universidade Federal de Sao Paulo, São Paulo, Brazil
Intensive Care
Issue Date: 2021
Date: 2020-12-18
Publication information: Blood Purification 2021; 50(4-5): 520-530
Abstract: 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. 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. 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)}. 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.
DOI: 10.1159/000513425
Journal: Blood Purification
PubMed URL: 33341806
Type: Journal Article
Subjects: Acute kidney injury
Continuous renal replacement therapy
Intensive care unit
Severe acute respiratory syndrome coronavirus 2
Appears in Collections:Journal articles

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